在疑似感染性内心炎的患者中,与持续的细菌血症相关的因素
André Teixeira-Antunes1, Virgile Zimmermann1, Nicolas Fourré1
1Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Infection
|April 7, 2025
概括
疑似传染性内心炎 (IE) 的持续性细菌血症与金色葡萄球菌和骨关节感染 (BJIs) 有关. 及时的源控制干预和链球菌感染有助于快速的血液培养清除.
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
- 内部医学 内部医学
背景情况:
- 传染性内心炎 (IE) 是心脏内膜的严重感染.
- 持续的细菌血症使IE管理复杂化,并与较差的结果有关.
- 确定持续性细菌病的预测因素对于优化患者护理至关重要.
研究的目的:
- 确定可预测感染性内心炎 (IE) 疑似或确诊患者持续性细菌病的因素.
主要方法:
- 从2015年到2023年在瑞士大学医院进行的回顾性研究.
- 包括患有细菌血症和疑似IE的成年患者.
- 定义持久性细菌血症为抗生素开始后≥48小时的阳性血液培养.
主要成果:
- 黄金葡萄球菌是疑似IE中最常见的病原体 (45%).
- 持续性细菌血症发生在所有发作中的21%和确认的IE病例中的30%.
- 持续性细菌病的独立预测因素包括金黄色细菌,多个阳性血液培养组,耐药细菌,败血症,IE,中静脉导管相关的细菌病,以及急性本地骨关节感染 (BJIs).
- 链球菌细菌病和及时的源控制干预与快速的血液培养清除有关.
结论:
- 黄金葡萄球菌和BJIs与持续的细菌血症有显著的关联.
- 延迟的源控制干预措施增加了持续性细菌病的风险.
- 没有特定的心内病变被确定为IE发作中持续性细菌病的预测因素.
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