PDF(Sci-hub)
Abstract：
OBJECTIVE: To Assess changes in infective endocarditis (IE) epidemiology over the last 5 decades.
RESULTS: We searched the published literature using PubMed, MEDLINE, and EMBASE from inception until December 2011.
UNASSIGNED: Einstein Medical Center, Philadelphia, PA were also included. Criteria for inclusion in this systematic review included studies with reported IE microbiology, IE definition, description of population studied, and time frame. Two authors independently extracted data and assessed manuscript quality. One hundred sixty studies (27,083 patients) met inclusion criteria. Among hospital-based studies (n=142; 23,606 patients) staphylococcal IE percentage increased over time, with coagulase-negative staphylococcus (CNS) increasing over each of the last 5 decades (p<0.001) and Staphylococcus aureus (SA) in the last decade (21% to 30%; p<0.05). Streptococcus viridans (SV) and culture negative (CN) IE frequency decreased over time (p<0.001), while enterococcal IE increased in the last decade (p<0.01). Patient age and male predominance increased over time as well. In subgroup analysis, SA frequency increased in North America, but not the rest of the world. This was due, in part, to an increase in intravenous drug abuse IE in North America (p<0.001). Among population-based studies (n=18; 3,477 patients) no significant changes were found.
CONCLUSIONS: Important changes occurred in IE epidemiology over the last half-century, especially in the last decade. Staphylococcal and enterococcal IE percentage increased while SV and CN IE decreased. Moreover, mean age at diagnosis increased together with male:female ratio. These changes should be considered at the time of decision-making in treatment of and prophylaxis for IE.
RESULTS: We searched the published literature using PubMed, MEDLINE, and EMBASE from inception until December 2011.
UNASSIGNED: Einstein Medical Center, Philadelphia, PA were also included. Criteria for inclusion in this systematic review included studies with reported IE microbiology, IE definition, description of population studied, and time frame. Two authors independently extracted data and assessed manuscript quality. One hundred sixty studies (27,083 patients) met inclusion criteria. Among hospital-based studies (n=142; 23,606 patients) staphylococcal IE percentage increased over time, with coagulase-negative staphylococcus (CNS) increasing over each of the last 5 decades (p<0.001) and Staphylococcus aureus (SA) in the last decade (21% to 30%; p<0.05). Streptococcus viridans (SV) and culture negative (CN) IE frequency decreased over time (p<0.001), while enterococcal IE increased in the last decade (p<0.01). Patient age and male predominance increased over time as well. In subgroup analysis, SA frequency increased in North America, but not the rest of the world. This was due, in part, to an increase in intravenous drug abuse IE in North America (p<0.001). Among population-based studies (n=18; 3,477 patients) no significant changes were found.
CONCLUSIONS: Important changes occurred in IE epidemiology over the last half-century, especially in the last decade. Staphylococcal and enterococcal IE percentage increased while SV and CN IE decreased. Moreover, mean age at diagnosis increased together with male:female ratio. These changes should be considered at the time of decision-making in treatment of and prophylaxis for IE.
摘要：
目的：评估过去50年感染性心内膜炎（IE）流行病学的变化。
结果：我们使用PubMed搜索了已发表的文献，MEDLINE,和EMBASE从成立到2011年12月。
■爱因斯坦医学中心,费城,PA也包括在内。纳入本系统综述的标准包括已报道的IE微生物学研究，IE定义，对所研究人口的描述，和时间框架。两位作者独立提取数据并评估手稿质量。一百六十项研究（27,083例患者）符合纳入标准。在以医院为基础的研究中（n=142;23,606名患者），葡萄球菌IE百分比随着时间的推移而增加，凝固酶阴性葡萄球菌（CNS）在过去5年中每年都在增加（p<0.001），而金黄色葡萄球菌（SA）在过去10年中在增加（21％至30％；p<0.05）。草绿色链球菌（SV）和培养阴性（CN）IE频率随时间降低（p<0.001），而肠球菌性IE在过去十年中有所增加(p<0.01)。患者年龄和男性优势也随着时间的推移而增加。在亚组分析中，SA频率在北美增加，但不是世界其他地方。这是由于，在某种程度上,北美静脉注射药物滥用IE的增加(p<0.001)。在基于人群的研究中（n=18；3,477名患者）没有发现显着变化。
结论：在过去的半个世纪中，IE流行病学发生了重要变化，尤其是在过去的十年里。葡萄球菌和肠球菌IE百分比增加，而SV和CNIE降低。此外，诊断时的平均年龄与男女比例一起增加。在作出治疗和预防IE的决策时，应考虑这些变化。
结果：我们使用PubMed搜索了已发表的文献，MEDLINE,和EMBASE从成立到2011年12月。
■爱因斯坦医学中心,费城,PA也包括在内。纳入本系统综述的标准包括已报道的IE微生物学研究，IE定义，对所研究人口的描述，和时间框架。两位作者独立提取数据并评估手稿质量。一百六十项研究（27,083例患者）符合纳入标准。在以医院为基础的研究中（n=142;23,606名患者），葡萄球菌IE百分比随着时间的推移而增加，凝固酶阴性葡萄球菌（CNS）在过去5年中每年都在增加（p<0.001），而金黄色葡萄球菌（SA）在过去10年中在增加（21％至30％；p<0.05）。草绿色链球菌（SV）和培养阴性（CN）IE频率随时间降低（p<0.001），而肠球菌性IE在过去十年中有所增加(p<0.01)。患者年龄和男性优势也随着时间的推移而增加。在亚组分析中，SA频率在北美增加，但不是世界其他地方。这是由于，在某种程度上,北美静脉注射药物滥用IE的增加(p<0.001)。在基于人群的研究中（n=18；3,477名患者）没有发现显着变化。
结论：在过去的半个世纪中，IE流行病学发生了重要变化，尤其是在过去的十年里。葡萄球菌和肠球菌IE百分比增加，而SV和CNIE降低。此外，诊断时的平均年龄与男女比例一起增加。在作出治疗和预防IE的决策时，应考虑这些变化。
