Secular trends in the epidemiology and clinical characteristics of Enterococcus faecalis infective endocarditis at a referral center (2007-2018)
Secular trends in the epidemiology and clinical characteristics of Enterococcus faecalis infective endocarditis at a referral center (2007-2018)
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DOI：
10.1007/s10096-020-04117-x
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发表时间：
2021-01-06
影响因子：
4.5
通讯作者：
Almirante, Benito
中科院分区：
文献类型：
--
作者：
Escola-Verge, Laura;Fernandez-Hidalgo, Nuria;Almirante, Benito
本研究的目的是分析流行性出血热的流行病学和临床变化。2007年至2018年期间在转诊中心治疗的所有明确IE发作都被前瞻性登记，并使用趋势测试来研究一段时间的病因。将EFIE病例分为三个时期，分析其临床差异。回顾收集2010至2018年间粪肠球菌单菌血症(EFMB)的所有病例和超声心动图的百分比。研究对象为648例IE患者。我们发现EFIE的比例有所增加(2007年为15%，2018年为25.3%，P=0.038)，在上一次研究期间成为IE最常见的致病因素。分析了108例流行性出血热病例(2007年至2010年，30例；2011年至2014年，22例；2015年至2018年，56例)。末期患者年龄较大(中位数70.9vs66.5vs76.3岁，P=0.015)，腹部部位多(20%vs13.6%vs42.9%，P=0.014)，手术适应证少(63.3%vs54.6%vs32.1%，P=0.014)，住院病死率(30%vs18.2%vs12.5%，P=0.139)。超声心动图检查的比例有所增加(2010年为30%，2018年为51.2%，P=0.014)，诊断为流行性出血热患者(2010年为15%，2018年为32.6%，P=0.004)。粪肠球菌是我们中心IE的一个日益增加的原因，很可能是由于超声心动图的百分比增加所致。应深入研究EFIE临床变化的相关因素。
The aim of the study was to analyze the epidemiological and clinical changes in EFIE. All definite IE episodes treated at a referral center between 2007 and 2018 were registered prospectively, and a trend test was used to study etiologies over time. EFIE cases were divided into three periods, and clinical differences between them were analyzed. All episodes of E. faecalis monomicrobial bacteremia (EFMB) between 2010 and 2018 and the percentage of echocardiograms performed were retrospectively collected. Six hundred forty-eight IE episodes were studied. We detected an increase in the percentage of EFIE (15% in 2007, 25.3% in 2018, P = 0.038), which became the most prevalent causative agent of IE during the last study period. One hundred and eight EFIE episodes were analyzed (2007-2010, n = 30; 2011-2014, n = 22; 2015-2018, n = 56). The patients in the last period were older (median 70.9 vs 66.5 vs 76.3 years, P = 0.015) and more frequently had an abdominal origin of EFIE (20% vs 13.6% vs 42.9%, P = 0.014), fewer indications for surgery (63.3% vs 54.6% vs 32.1%, P = 0.014), and non-significantly lower in-hospital mortality (30% vs 18.2% vs 12.5%, P = 0.139). There was an increase in the percentage of echocardiograms performed in patients with EFMB (30% in 2010, 51.2% in 2018, P = 0.014) and EFIE diagnoses (15% in 2010, 32.6% in 2018, P = 0.004). E. faecalis is an increasing cause of IE in our center, most likely due to an increase in the percentage of echocardiograms performed. The factors involved in clinical changes in EFIE should be thoroughly studied.