Infection: 金黄色葡萄球菌是心脏手术相关的感染性心内膜炎的主要原因

2021-10-19 MedSci原创 MedSci原创

心血管植入式电子设备 (CIED) 包括永久性起搏器 (PPM)、植入式心律转复除颤器 (ICD) 和心脏再同步治疗仪 (CRT)。

       血管植入式电子设备 (CIED) 包括永久性起搏器 (PPM)、植入式心律转复除颤器 (ICD) 和心脏再同步治疗仪 (CRT),多年来,尽管装置植入愈发成熟、技术进步和经验更加完善,但心脏装置相关感染的比率也在逐年增加。其中感染性心内膜炎的发生率占到了10%,死亡率约17.4-36%。因此,本项研究旨在表征心血管植入式电子设备相关感染性心内膜炎(CIED-IE)概况、时间趋势和预后因素。

 

      研究人员收集了1992年至2017年在雷恩大学医院诊断为CIED-IE的患者资料,并详细收集了(1) 感染的临床体征;(2) 通过血液和/或CIED培养的微生物记录;(3) 瓣膜赘生物的样本。该队列分为三个时期:1992-1999、2000-2008和2009-2017,然后研究人员对不同时期的CIED-IE分别作了统计分析。

 

      总共纳入了199名患者(51名女性,148名男性,中位年龄73岁),CIED-IE感染中,158 患者有PPM(79%)、24患者有 ICD(12%),17名患者有 CRT(9%))。研究发现感染性心内膜炎的主要病原体为凝固酶阴性葡萄球菌(CoNS:n = 86, 43%)、金黄色葡萄球菌(n = 60, 30%)和其他革兰氏阳性球菌(n = 28, 14%)。 金黄色葡萄球菌的出现是 CIED-IE 的主要原因。与一年死亡率独立相关的因素是慢性阻塞性肺疾病(COPD:HR,3.84 [1.03–6.02],P = 0.03)、左侧心内膜炎(HR 2.25 [1.09-4.65],P = 0.03)、CoNS 以外的病原体(HR 3.16 [1.19-8.39],P = 0.02)和 CIED 移除再植入(HR 0.41 [0.2–0.83],P  = 0.01)。

 

       本项研究证实金黄色葡萄球菌已成为 CIED-IE 的主要原因,同时,左侧心内膜炎、COPD、CoNS 病菌以及没有 CIED 移除/再植入是一年死亡率的独立危险因素。

 

原始出处:

Jean-Marie Urien. Et al. The emergence of Staphylococcus aureus as the primary cause of cardiac device-related infective endocarditis. Infection.2021.

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    2022-07-18 Doctoryangbai

    高度重视金葡菌

    0

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1233084, encodeId=c167123308447, content=高度重视金葡菌, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Mon Jul 18 00:24:13 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655515, encodeId=c7ae1655515ba, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Wed Aug 17 20:32:40 CST 2022, time=2022-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1708667, encodeId=cbd01e08667df, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Aug 25 11:32:40 CST 2022, time=2022-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305060, encodeId=a7971305060fe, content=<a href='/topic/show?id=4b8896242d4' target=_blank style='color:#2F92EE;'>#金黄色葡萄球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96242, encryptionId=4b8896242d4, topicName=金黄色葡萄球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c25323, createdName=jambiya, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350762, encodeId=4b2a1350e62a0, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524463, encodeId=d53415244637a, content=<a href='/topic/show?id=f0f998396d' target=_blank style='color:#2F92EE;'>#Infection#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9839, encryptionId=f0f998396d, topicName=Infection)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76e211601877, createdName=lidong44, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596934, encodeId=e426159693465, content=<a href='/topic/show?id=a3e68823477' target=_blank style='color:#2F92EE;'>#葡萄球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88234, encryptionId=a3e68823477, topicName=葡萄球菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11e618440395, createdName=手留余香, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061846, encodeId=b8ce1061846a6, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/06/95275c4ca065065e4f37aad1bc1e360b.jpg, createdBy=0d2a5135634, createdName=14665f9am03暂无昵称, createdTime=Tue Oct 19 15:20:12 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061824, encodeId=b53a1061824ee, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Oct 19 13:53:37 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 14665f9am03暂无昵称

    学习了

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1233084, encodeId=c167123308447, content=高度重视金葡菌, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLyXfB3bOYOsDt885AsrYWhiaRtRdPh9aZlXugm7XErBVXusv5fJLIKWTicmjSQcOibDiaLzE2YMD44PA/132, createdBy=49f71976501, createdName=Doctoryangbai, createdTime=Mon Jul 18 00:24:13 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655515, encodeId=c7ae1655515ba, content=<a href='/topic/show?id=7c2853311ac' target=_blank style='color:#2F92EE;'>#感染性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53311, encryptionId=7c2853311ac, topicName=感染性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=583d24724321, createdName=charl1234575, createdTime=Wed Aug 17 20:32:40 CST 2022, time=2022-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1708667, encodeId=cbd01e08667df, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Thu Aug 25 11:32:40 CST 2022, time=2022-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305060, encodeId=a7971305060fe, content=<a href='/topic/show?id=4b8896242d4' target=_blank style='color:#2F92EE;'>#金黄色葡萄球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96242, encryptionId=4b8896242d4, topicName=金黄色葡萄球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c25323, createdName=jambiya, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350762, encodeId=4b2a1350e62a0, content=<a href='/topic/show?id=a32d508e8c3' target=_blank style='color:#2F92EE;'>#心内膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50878, encryptionId=a32d508e8c3, topicName=心内膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524463, encodeId=d53415244637a, content=<a href='/topic/show?id=f0f998396d' target=_blank style='color:#2F92EE;'>#Infection#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9839, encryptionId=f0f998396d, topicName=Infection)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=76e211601877, createdName=lidong44, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596934, encodeId=e426159693465, content=<a href='/topic/show?id=a3e68823477' target=_blank style='color:#2F92EE;'>#葡萄球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88234, encryptionId=a3e68823477, topicName=葡萄球菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11e618440395, createdName=手留余香, createdTime=Thu Oct 21 01:32:40 CST 2021, time=2021-10-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061846, encodeId=b8ce1061846a6, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/06/95275c4ca065065e4f37aad1bc1e360b.jpg, createdBy=0d2a5135634, createdName=14665f9am03暂无昵称, createdTime=Tue Oct 19 15:20:12 CST 2021, time=2021-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1061824, encodeId=b53a1061824ee, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Tue Oct 19 13:53:37 CST 2021, time=2021-10-19, status=1, ipAttribution=)]
    2021-10-19 yangchou

    好文章,谢谢分享。

    0

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