中等风险患者口腔链球菌内心炎的增加:指导方针变更对内心炎预防的影响
Jana Epprecht1, Bruno Ledergerber1, Michelle Frank2
1Department of Infectious Disease and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
JACC. Advances
|September 18, 2024
概括
随着指导方针的改变,中等风险的患者出现了口腔链球菌感染性内心炎 (IE) 的增加. 先天性门异常可能需要扩大抗生素预防的指示.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 口腔健康 口腔健康
背景情况:
- 口腔细菌和传染性内心炎 (IE) 之间的联系已经得到充分证实.
- 抗生素预防 (AP) 指南于2007/2008年更新,将使用限制在高风险患者身上.
研究的目的:
- 为了确定是否由口腔链球菌引起的传染性内心炎 (IE) 在指导方针变化后在中度风险患者中增加.
- 分析不同患者风险组口腔链球菌IE的趋势.
主要方法:
- 分析了来自苏黎世大学医院 (2000-2022) 的成人IE病例.
- 根据欧洲心脏病学会和瑞士指南,患者的风险分层.
- 后勤回归模型评估了2000-2008年和2009-2022年间口腔链球菌IE比例的变化.
主要成果:
- 在752例IE病例中,口腔链球菌引起了22%.
- 在中度风险患者中,口腔链球菌IE的比例从24% (2000-2008) 增加到39% (2009-2022).
- 中等风险患者的口腔链球菌IE风险增加了2.59倍,指南后的变化,先天性膜异常是显著因素.
结论:
- 在AP指南限制后,口腔链球菌IE发病率在中度风险患者中增加.
- 应考虑为中度风险患者,特别是患有先天性膜异常的患者扩大AP指示.
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