心脏植入式电子设备的非葡萄球菌感染
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
概括
心脏植入式电子设备 (CIED) 的非葡萄球菌感染是常见的和多样化的,具有较低的毒性. 及时诊断和广泛的抗生素覆盖对于管理这些CIED感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 医疗设备感染 医疗设备感染
背景情况:
- 心脏植入式电子设备 (CIED) 的使用越来越多,导致设备感染的增加.
- 非葡萄球菌CIED感染占CIED所有感染的10-30%,但仍然不太了解.
研究的目的:
- 调查非葡萄球菌CIED感染的特征,临床表现和结果.
- 确定这些感染的风险因素和最佳管理策略.
主要方法:
- 从4所学术医院 (2002-2009) 的医院记录的回顾性审查.
- 对504名患有CIED感染的患者进行分析,重点关注80名患有非葡萄球菌感染的患者.
- 评估设备持续时间,先前的操纵,症状持续时间和治疗.
主要成果:
- 非葡萄球菌感染占CIED感染的16%,平均感染发病时间为植入后109周.
- 44%的患者曾经接受过设备操纵;16%的患者出现了CIED相关的内心炎.
- 在5例中发生了二次格拉姆阴性细菌的播种;50%的患者接受了不适当的抗微生物覆盖.
结论:
- 非葡萄球菌CIED感染很常见,多样化,一般具有较低的毒性和死亡率 (4%).
- 非葡萄球菌有机体可以二次播种CIED,需要在患有血流感染的患者中高度怀疑.
- 在等待微生物学结果时,建议在怀疑CIED感染时进行经验性格拉姆阳性和格拉姆阴性抗菌覆盖.
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