プロテス弁内心炎の現代の臨床プロファイルと結果
Andrew Wang1, Eugene Athan, Paul A Pappas
1Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA. a.wang@duke.edu
JAMA
|March 30, 2007
まとめ
プロステス弁内心炎 (PVE) は大きな懸念事項であり,Staphylococcus aureusが主な原因である. 医療関連感染症とPVE合併症は,高い入院死亡率を強く予測しています.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
背景:
- プロステス弁内心炎 (PVE) は,著しい死亡率と罹患率を示しています.
- PVEの臨床プロファイルとアウトカムに関する現在のデータは限られている.
研究 の 目的:
- PVEの罹患率,臨床的特徴,アウトカムを決定する.
- 医療関連感染症がPVEに与える影響を調査する.
- PVE患者における入院死亡率の予後要因を特定する.
主な方法:
- 予見的,観察的なコホート研究で,PVEがはっきりと認められた556人の患者が参加した.
- 28カ国の61の医療センターで収集されたデータ (2000年-2005年のエンドカルディティス前向きコホート研究に関する国際協力).
- 測定された主なアウトカムは,入院死亡率でした.
主要な成果:
- PVEは,感染性内臓炎症例の20.1%を占めました.
- Staphylococcus aureusは最も一般的な病原体 (23.0%) であり,その次は凝固性陰性スタフィロコーシ (16.9%) であった.
- 医療関連のPVEは,症例の36.5%で発生し,多くの場合,移植後の最初の1年以内に発生しました.
- 病院での死亡率は22.8%で,高齢化,医療関連感染症,S. aureus,心不全,脳卒中,,バクテリアemiaによって予測されました.
結論:
- PVEは,世界的に感染性エンドカルディティスの症例の相当な割合を占めています.
- 黄金球菌 (Staphylococcus aureus) はPVEの主要な原因である.
- 医療関連感染症とPVE合併症は,患者のアウトカムと死亡率に大きな影響を与えます.
関連する概念動画
Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Endocarditis I: Introduction
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Pericarditis II: Clinical Features and Diagnostic Tests
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...


