感染性内心炎住院患者的发病率,微生物学和结果
Anoop S V Shah1,2, David A McAllister3, Peter Gallacher1
1British Heart Foundation Centre for Cardiovascular Science (A.S.V.S., P.G., F.A., J.H., K.K.L., R.B., A.A., N.L.M., D.E.N.), University of Edinburgh, United Kingdom.
Circulation
|May 16, 2020
概括
感染性内心炎的发病率保持稳定,但在老年人中发病率翻了一番. 尽管指导方针发生了变化,但黄金葡萄球菌和肠球菌与死亡率的增加有关.
科学领域:
- 心脏病学
- 传染性疾病
- 公共卫生
背景情况:
- 感染性内心炎 (IE) 尽管在治疗方面取得了进展,但仍存在重大死亡和发病风险.
- 了解IE发病率,微生物学和结果的时间趋势对于改进治疗策略至关重要.
研究的目的:
- 分析苏格兰感染性内心炎的发病率,微生物学和结果的时间变化.
- 评估更新的国家抗生素预防指南对IE发病率的影响.
主要方法:
- 从1990年到2014年,一项苏格兰范围的个人关联研究确定了因IE住院的患者.
- 数据与国家微生物学,处方和死亡数据集进行了链接,以分析趋势.
- 间断时间序列分析评估了2008年指南更新之前和之后的发病率变化.
主要成果:
- 原始IE住院率最初增加 (1990-1995年),然后稳定,在2008年指南更新后没有显著变化.
- 在80岁以上的患者中,发病率在1990年至2014年间翻了一番.
- 在研究期间,男性和女性的病例死亡率均下降.
- 在血液培养中发现的最常见的病原体是葡萄球菌和链球菌 (从2008年开始).
- 黄金葡萄球菌和肠杆菌菌与1年死亡率显著增加有关.
结论:
- 根据最新的抗生素预防指南,该研究没有发现原始感染性内心炎发病率的变化.
- 在老年人 (80岁以上) 中观察到IE发病率显著增加.
- 在IE患者中,黄金葡萄球菌和肠球菌感染的死亡风险较高.
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