关键词: 心内膜炎,细菌性, 葡萄球菌

Abstract:

Objective The purpose of this paper is to explore the clinical and etiological characteristic of patients with staphylococcus infective endocarditis (IE), to provide evidence for diagnosis and treatment.Methods This retrospective study included a cohort of 46 staphylococcus IE patients hospitalized in Peking Union Medical College Hospital from 2011 to 2018.Results The incidence of staphylococcus IE was 46 cases, accounted for 10.8% among 425 IE inpatients at the same time. Fever (97.8%) was the most common clinical presentation, followed by anemia (73.3%) and cardiac murmur (63.0%). Congestive heart failure (52.2%) and embolism (43.5%) were the most common complications. Among 46 staphylococcus strains, 38 stains (82.6%) were S. aureus (percentage of methicillin-resistant was 31.6%), while 8 strains (17.4%) were S. coagulase negative (percentage of methicillin-resistant was 75.0%). Four (8.7%) died during hospitalization. Compared with streptococcus IE, staphylococcus IE was associated with higher prevalence of underlying chronic disease (P=0.008), higher prevalence of complicated septic shock (P<0.01), lower prevalence of left side IE (P<0.01) and higher prevalence of prosthetic valves/devices (P<0.01); abscess formation were more frequent in staphylococcus IE (P=0.005). Inpatients with staphylococcus IE were more likely to have higher mortality and/or non-healing rate (P=0.015).Conclusion Staphylococcus (mostly S. aureus) is an important pathogen of IE. Compared with Streptococcus IE, patients with staphylococcus IE are likely to have more severe disease, more comorbidities and complications, and a poor prognosis. Management of staphylococcus IE is a challenge to physicians.

Key words: endocarditis,bacterial, staphylococcus