Current trends and challenges in infective endocarditis.

IF 2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Current Opinion in Cardiology Pub Date : 2024-11-08 DOI:10.1097/HCO.0000000000001192
Shubh K Patel, Syed M Ali Hassan, Mahée Côté, Benjamin Leis, Bobby Yanagawa
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Abstract

Purpose of review: Infective endocarditis (IE) is a complex disease with increasing global incidence. This review explores recent trends in IE infection patterns, including healthcare-associated IE (HAIE), drug-use-associated IE (DUA-IE), multidrug-resistant organisms (MDROs), and challenges in managing prosthetic valve and device-related infections.

Recent findings: Staphylococcus aureus has emerged as the leading cause of IE, especially in HAIE and DUA-IE cases. Increasingly prevalent MDROs, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, pose further clinical challenges. Advances in molecular diagnostics have improved the detection of culture-negative endocarditis. The introduction of the AngioVAC percutaneous aspiration device promises to change the management of right and possibly some left sided IE. Multidisciplinary team management and early surgery have demonstrated improved outcomes including partnerships with psychiatry and addictions services for those with intravenous DUA-IE.

Summary: IE presents significant diagnostic and therapeutic challenges due to evolving infection patterns, MDROs, and HAIE. Early diagnosis using advanced imaging, appropriate early antimicrobial therapy, and multidisciplinary care, including timely surgery, are critical for optimizing patient outcomes.

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感染性心内膜炎的当前趋势和挑战。
审查目的:感染性心内膜炎(IE)是一种复杂的疾病,全球发病率不断上升。本综述探讨了 IE 感染模式的最新趋势,包括医疗相关 IE(HAIE)、药物使用相关 IE(DUA-IE)、耐多药菌(MDROs)以及人工瓣膜和装置相关感染的管理挑战:最近的研究结果:金黄色葡萄球菌已成为IE的主要病因,尤其是在HAIE和DUA-IE病例中。耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌等MDROs的日益流行给临床带来了更多挑战。分子诊断技术的进步提高了对培养阴性心内膜炎的检测能力。AngioVAC 经皮抽吸装置的问世有望改变右腔 IE 的治疗方法,也可能改变部分左腔 IE 的治疗方法。多学科团队管理和早期手术改善了治疗效果,包括与精神病学和成瘾服务部门合作,为静脉注射 DUA-IE 的患者提供治疗。利用先进的成像技术进行早期诊断、适当的早期抗菌治疗和多学科护理(包括及时手术)对于优化患者预后至关重要。
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来源期刊
Current Opinion in Cardiology
Current Opinion in Cardiology 医学-心血管系统
CiteScore
4.20
自引率
4.30%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.
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