Challenges in Infective Endocarditis

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• 作者：Thomas J. Cahill ; MBBS^a ; Larry M. Baddour ; MD^b ; Gilbert Habib ; MD^c ; ^d ; Bruno Hoen ; MD ; PhD^e ; Erwan Salaun ; MD^d ; Gosta B. Pettersson ; MD ; PhD^f ; Hans Joachim Schä ; fers ; MD^g ; Bernard D. Prendergast ; DM^h ; ^{bernard.prendergast@gstt.nhs.uk}
• 关键词：cardiac device infection ; infective endocarditis ; TAVR
• 刊名：Journal of the American College of Cardiology
• 出版年：2017
• 出版时间：24 January 2017
• 年：2017
• 卷：69
• 期：3
• 页码：325-344
• 全文大小：2707 K
• 卷排序：69

文摘

Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by infective endocarditis and outlines current and future strategies to limit its impact.