非HACEK格兰负细菌内心炎:一个多中心的回顾性病例控制研究.
Marine Sebillotte1, David Boutoille2, Charles Declerck3
1Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France.
Infectious diseases (London, England)
|June 24, 2023
概括
感染性内心炎 (IE) 是由非HACEK菌 (GNB) 引起的罕见但严重的疾病,通常与医疗保健接触或静脉注射药物使用有关. 这种疾病的死亡率很高,特别是在具有重大并发症的患者中.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 微生物学 微生物学
背景情况:
- 感染性内心炎 (IE) 是由非HACEK菌 (GNB) 引起的,目前尚不清楚,可能正在增加.
- 这项研究描述了非HACEK GNB IE,这是现代医学中可能出现的并发症.
研究的目的:
- 为了研究非HACEK格兰负菌根引起的传染性内心炎的特征,风险因素和结果.
- 为了比较非HACEK GNB IE 与其他细菌引起的 IE.
主要方法:
- 进行了一项观察性回顾性病例控制研究.
- 包括在2007年至2020年期间在法国六家医院诊断出确定的或可能的非HACEK GNB IE的成年患者.
- 根据医院所在地和诊断日期,每个病例都匹配了两个对照组 (由于其他细菌引起的IE).
主要成果:
- 非HACEK GNB占所有IE病例的2.4%,主要影响老年男性.
- 主要病原体包括大肠杆菌,Klebsiella sp.和Serratia marcescens,10%的病原体具有多药耐药性.
- 非HACEK GNB IE独立地与静脉注射药物使用,活跃瘤,血液透析和与医疗相关的感染有关.
- 尿路是最常见的感染来源,最近的侵入性手术也很常见.
- 非HACEK GNB IE显示血栓塞的风险较低,但一年死亡率高 (36%),恶性血病和肝硬化等并发病增加了死亡风险.
结论:
- 非HACEK GNB是IE的罕见原因,通常发生在患有复杂并发症的患者中,如末期脏病或瘤,或在静脉注射药物使用者中.
- 与医疗保健相关的IE占非HACEK GNB IE病例的很大一部分.
- 高死亡率凸显了这种疾病的严重性和需要有针对性的管理策略.
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