心臓インプラント可能な電子機器の非ステフィロコック感染症
George M Viola1, Leah L Awan, Rabih O Darouiche
1Baylor College of Medicine, Department of Medicine, Section of Infectious Diseases, One Baylor Plaza, BCM 286, Room N1319, Houston, TX 77030, USA. viola@bcm.edu
Circulation
|May 5, 2010
まとめ
心臓インプラント可能な電子機器 (CIED) の非菌根菌感染症は一般的で多様で,毒性が低い. 迅速な診断と広範囲の抗生物質の適用は,これらのCIED感染症の管理に不可欠です.
科学分野:
- 感染症 感染症は感染症です.
- 心臓病学 心臓病学
- 医療機器の感染 医療機器の感染
背景:
- 心臓埋め込み電子機器 (CIED) はますます使用され,デバイスの感染が増加しています.
- スタフィロコーカ以外のCIED感染症は,CIED感染症全体の10-30%を占めるが,依然として十分に理解されていない.
研究 の 目的:
- 非スタフィロコック性CIED感染症の特徴,臨床表現,およびアウトカムを調査する.
- これらの感染症の危険因子と最適な管理戦略を特定する.
主な方法:
- 4つの学術病院 (2002年~2009年) の病院記録を遡及的にレビューした.
- CIED感染症の504人の患者を分析し,非ステフィロコック感染症の80人に焦点を当てました.
- デバイスの持続時間,以前の操作,症状の持続時間,および治療の評価.
主要な成果:
- 非スタフィロコーカ感染はCIED感染の16%を占め,平均感染発症期間は植入後109週間でした.
- 患者の44%は以前にデバイス操作を受けた;16%はCIEDに関連した心内膜炎を示した.
- グラム陰性細菌の二次発芽は5例で発生し,50%は不適切な抗菌剤の接種を受けた.
結論:
- 非スタフィロコックスのCIED感染症は,一般的で多様で,一般的には低毒性と死亡率 (4%) を有する.
- スタフィロコック以外の生物は二次的にCIEDの種を蒔くことができるため,血流感染症の患者では高度な疑いが必要になります.
- 微生物学的結果が発表されるまで,CIED感染の疑いがある場合は,経験的なグラム陽性およびグラム陰性抗菌剤の適用が推奨されます.
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