感染性内心炎的管理考虑因素:一篇综述
Andrew Wang1, Jeffrey G Gaca2, Vivian H Chu3
1Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
JAMA
|July 5, 2018
概括
传染性内心炎的发病率正在上升,主要原因是与医疗保健相关的感染,设备感染和静脉注射药物的使用. 治疗需要仔细考虑新出现的研究,抗生素耐药性以及患者特有的因素.
科学领域:
- 心脏病学
- 传染性疾病
- 医学研究
背景情况:
- 传染性内心炎 (IE) 的发病率正在增加,影响不同患者群体.
- 医疗保健相关的感染,心脏器械感染和静脉注射药物使用有助于IE流行病学.
- 黄金葡萄球菌是高收入国家IE的主要病因.
研究的目的:
- 审查传染性内心炎的流行病学.
- 讨论目前的诊断方式及其局限性.
- 突出感染性内心炎的管理方面的挑战和考虑.
主要方法:
- 对传染性内心炎流行病学和管理的当前文献的综述.
- 分析诊断技术,包括心声学,血液培养和高级成像.
- 评估治疗策略,包括抗生素和手术.
主要成果:
- 每10万人中约有15人患有IE, 发病率正在上升.
- 黄金葡萄球菌占病例的40%,需要新的抗生素方法.
- 心声学和血液培养仍然是主要的诊断工具,并补充了先进的成像和分子测试.
结论:
- 感染性内心炎的治疗需要个性化治疗策略.
- 新出现的抗生素耐药性和复杂的患者因素需要谨慎的临床决策.
- 准则提供建议, 但个体患者的特征是最重要的最佳结果.
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