感染症性内心炎の時間的傾向:ミネソタ州オルムステッド郡の集団ベースの研究
Imad M Tleyjeh1, James M Steckelberg, Hani S Murad
1Department of Medicine, Division of Infectious Diseases, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn, USA. tleyjeh.imad@mayo.edu
JAMA
|June 24, 2005
まとめ
オルムステッド郡では,感染症性内心炎 (IE) の発生率は30年以上にわたって安定したままでした. ビリダンス群のストレプトコックは,Staphylococcus aureusよりも,IEの最も頻繁な原因でした.
科学分野:
- エピデミオロジー エピデミオロジー
- 感染症 感染症は感染症です.
- 心臓病学 心臓病学
背景:
- 感染性内心炎 (IE) の発生率における流行病学的変化に関する人口ベースのデータは限られている.
- タイムトレンドを理解することは,公衆衛生戦略と資源配分において極めて重要です.
研究 の 目的:
- 感染症性内心炎 (IE) の発生率における時間的な傾向を評価する.
- 時間の経過とともにIEの臨床的特徴の変化を評価する.
主な方法:
- ミネソタ州オルムステッド郡のロチェスター疫学プロジェクトを利用した人口ベースの調査.
- 1970年から2000年までの102人の住人の107件のIEエピソードを分析し,修正されたデューク基準を使用して診断しました.
主要な成果:
- 年齢と性別を調整したIEの発生率は,研究期間中に有意な変化を示せず,10万人年あたり5.0~7.0例であった.
- ウイルダンス・グループ・ストレプトコックは,最も一般的な病原体であり続け,次にスタフィロコッカス・オーレウスが続いたが,いずれにも重要な時間的な傾向が検出されなかった.
- 根底にある心疾患を有する患者の間では,義肢弁IEとミトラ弁の転落が増加する傾向が見られたが,関節性心疾患は減少する傾向を示した.
結論:
- このコミュニティベースの研究では,30年以上にわたってIE発生率に実質的な変化は見られなかった.
- この集団におけるIEの主な病原体として,Viridans群のストレプトコックは一貫してStaphylococcus aureusを上回った.
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