Infective endocarditis by carbapenem-resistant Gram-negative bacteria - a systematic review.

IF 1.7 Q3 INFECTIOUS DISEASES GERMS Pub Date : 2024-06-30 eCollection Date: 2024-06-01 DOI:10.18683/germs.2024.1427
Konstantinos Pitsikakis, Michail Skandalakis, Konstantinos Fragkiadakis, Stella Baliou, Petros Ioannou
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Abstract

Introduction: Infective endocarditis (IE) is a disease that may frequently lead to significant morbidity and is associated with high mortality rates. Even though IE is classically caused by Gram-positive bacteria, Gram-negative bacteria may seldom cause IE. Antimicrobial resistance (AMR) may pose significant problems in treating IE, especially for carbapenem-resistant pathogens. This study aimed to review all cases of IE by carbapenem-resistant Gram-negative bacteria in a systematic way and present information on epidemiology, clinical findings, treatment, and outcomes.

Methods: A systematic review of PubMed, Cochrane Library, and Scopus (all published studies up to 6 August 2023) for published studies providing information on epidemiology, clinical findings, treatment, and outcomes of IE by carbapenem-resistant Gram-negative bacteria was performed.

Results: A total of 24 studies containing data from 26 patients were included. Among all patients, 53.9% were male, and the median age was 66 years. Among all patients, 38.5% had a history of a prosthetic valve. The most commonly affected valve was the aortic, followed by the mitral valve. Fever, sepsis, emboli, and shock were the most frequent clinical findings. The most commonly isolated pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. Aminoglycosides, colistin, cephalosporins, and carbapenems were the most commonly used antimicrobials. Surgery was performed in 53.8% of patients. Mortality was 38.5%.

Conclusions: The development of infection control measures and antimicrobial stewardship interventions is needed to reduce the spread of AMR and the likelihood of this fatal infection.

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耐碳青霉烯革兰阴性菌感染性心内膜炎--系统综述。
导言:感染性心内膜炎(IE)是一种可能经常导致严重发病和高死亡率的疾病。尽管 IE 通常是由革兰氏阳性菌引起的,但革兰氏阴性菌也很少引起 IE。抗菌药耐药性(AMR)可能会给治疗 IE 带来重大问题,尤其是对碳青霉烯类耐药的病原体。本研究旨在系统回顾所有由耐碳青霉烯类革兰氏阴性菌引起的 IE 病例,并提供有关流行病学、临床发现、治疗和结果的信息:方法:对PubMed、Cochrane Library和Scopus(截至2023年8月6日的所有已发表研究)上发表的、提供耐碳青霉烯类革兰阴性菌IE的流行病学、临床发现、治疗和结果信息的研究进行了系统性回顾:结果:共纳入 24 项研究,包含 26 名患者的数据。在所有患者中,53.9%为男性,年龄中位数为66岁。在所有患者中,38.5%有人工瓣膜病史。最常受影响的瓣膜是主动脉瓣,其次是二尖瓣。发热、败血症、栓塞和休克是最常见的临床表现。最常分离出的病原体是铜绿假单胞菌、肺炎克雷伯菌和鲍曼不动杆菌。氨基糖苷类、秋水仙碱、头孢菌素和碳青霉烯类是最常用的抗菌药物。53.8%的患者接受了手术治疗。死亡率为 38.5%:结论:需要制定感染控制措施和抗菌药物管理干预措施,以减少AMR的传播和发生这种致命感染的可能性。
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来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
期刊最新文献
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