• 作者：Mariam Noureddine^a ; ^{mariamnoureddine@hotmail.com} ; Javier de la Torre^a ; Radka Ivanova^b ; Francisco José ; Martí ; nez^c ; Jose Marí ; a Lomas^c ; Antonio Plata^d ; Juan Gá ; lvez^e ; Jose Marí ; a Reguera^d ; Josefa Ruiz^b ; Carmen Hidalgo^f ; Rafael Luque^g ; Marí ; a Victoria Garcí ; a-L&#243 ; pez^h ; Arí ; stides de Alarc&#243 ; n^g ; por el Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI)^&loz ;
• 关键词：Endocarditis infecciosa ; Bacilos gram negativos ; Epidemiologí ; a
• 刊名：Enfermedades Infecciosas y Microbiolog铆a Cl铆nica
• 出版年：2011
• 期刊代码：pca153_0213005X
• 类别：med
• 出版时间：April 2011
• 卷：29
• 期：4
• 页码：276-281
• 文件大小：156 K

lass="h4">Introduction

The aim of this study is to describe the epidemiological, clinical characteristics, and outcome of patients with left-side endocarditis caused by gram-negative bacteria.

lass="h4">Method

Prospective multicenter study of left-sided infective endocarditis reported in the Andalusian Cohort for the Study of Cardiovascular Infections between 1984 and 2008.

lass="h4">Results

Among the 961 endocarditis, 24 (2.5%) were caused by gram-negative bacilli. The most common pathogens were Escherichia coli, Pseudomonas aeruginosa and Salmonella enterica. Native valves (85.7%) were mainly affected, most of them with previous valve damage (57%). Comorbidity was greater (90%vs 39%; P = .05) than in endocarditis due to other microorganism, the most frequent being, diabetes, hepatic cirrhosis and neoplasm. A previous manipulation was found in 47.6%of the cases, and 37%were considered hospital-acquired. Renal failure (41%), central nervous system involvement (33%) and ventricular dysfunction (45%) were the most frequent complications. Five cases (21%) required cardiac surgery, mostly due to ventricular dysfunction. More than 50%of cases were treated with aminoglycosides, but this did not lead to a better outcome or prognosis. Mortality (10 patients) was higher than that reported with other microorganisms (41%vs 35%; P = .05).

lass="h4">Conclusions

Left-sided endocarditis due to gram-negative bacilli is a rare disease, which affects patients with major morbidities and often with a previous history of hospital manipulations. Cardiac, neurological and renal complications are frequent and associated with a high mortality. The association of aminoglycosides in the antimicrobial treatment did not involve a better outcome or prognosis.