流行病学,时间,和复发性无心脏病的二次预防
Zachary A Yetmar1,2, Ryan B Khodadadi1, Supavit Chesdachai1
1Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Open forum infectious diseases
|April 1, 2024
概括
复发性无心脏病发生在5%的患者中. 二次预防没有显著降低复发风险,这表明它可能不仅仅适用于这种感染.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 流行病学 流行病学
背景情况:
- 诺卡迪亚感染主要影响免疫力低下的人和患有慢性肺病的人.
- 诺卡迪亚感染的复发是已知的临床挑战.
- 关于复发性无心病的流行病学和二次预防的疗效的数据有限.
研究的目的:
- 调查初级治疗后诺卡迪亚复发的发生率和时间.
- 评估二次预防预防预防诺卡迪亚复发的有效性.
- 分析与诺卡迪亚复发相关的因素.
主要方法:
- 对患有无心脏病的成年人进行多中心,回顾性队列研究 (2011年11月 - 2022年4月).
- 包括完成初级治疗并至少进行30天的随访的患者.
- 倾向性得分匹配被用来评估二次预防对复发的影响.
主要成果:
- 在5.0%的患者 (15/303) 中观察到复发性无心脏病.
- 治疗后60天或2-3年内通常会出现复发.
- 二次预防,主要是三甲-硫甲,与复发风险降低无关 (HR,0.96;95% CI,0.24-3.83).
- 大多数复发病例都有良好的结果,没有死亡报告.
结论:
- 复发性无心病可以表现为早期 (同一种物种) 或晚期 (新物种).
- 目前的数据不支持对非心脏病的二次预防的常规使用,因为缺乏证明的疗效.
- 复发性感染的有利结果表明,在长期使用抗生素进行预防时应谨慎使用.
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