Infective endocarditis
Infective endocarditis
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DOI：
10.1038/nrdp.2016.59
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发表时间：
2016-09-01
影响因子：
81.5
通讯作者：
Fowler, Vance G., Jr.
中科院分区：
文献类型：
--
作者：
Holland, Thomas L.;Baddour, Larry M.;Fowler, Vance G., Jr.
感染性心内膜炎（IE）是一种罕见的、危及生命的疾病，即使在存活并治愈的患者中也会产生长期影响。IE不成比例地影响那些有潜在结构性心脏病的患者，并且越来越多地与医疗保健接触相关，特别是在有血管内假体材料的患者中。在致病生物体的菌血症的情况下，受感染的植物可能是入侵微生物与宿主免疫系统之间复杂相互作用的最终结果。一旦建立，IE几乎可以涉及身体的任何器官系统。IE的诊断可能很难建立，结合临床、微生物学和超声心动图结果的策略已被编入修改后的杜克标准。在血培养阴性IE的情况下，诊断可能特别具有挑战性，并且已经开发了新的微生物和成像技术来确定其存在。一旦确诊，IE最好由具有传染病，心脏病学和心脏外科专业知识的多学科团队进行管理。预防IE的抗生素预防仍然存在争议。开发针对IE常见细菌原因的疫苗的努力正在进行中，但尚未产生商业化产品。
Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with health care contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system. Once established, IE can involve almost any organ system in the body. The diagnosis of IE may be difficult to establish and a strategy that combines clinical, microbiological and echocardiography results has been codified in the modified Duke criteria. In cases of blood culture-negative IE, the diagnosis may be especially challenging, and novel microbiological and imaging techniques have been developed to establish its presence. Once diagnosed, IE is best managed by a multidisciplinary team with expertise in infectious diseases, cardiology and cardiac surgery. Antibiotic prophylaxis for the prevention of IE remains controversial. Efforts to develop a vaccine that targets common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.