Abstract:
The European Society of Cardiology (ESC) 2023 guidelines for the management of infective endocarditis (IE) stress that a multidisciplinary approach is needed to manage patients with IE. In our view, the guidelines do not include the relevant perspectives from modern microbiology. The diagnostic criteria for IE were changed in the ESC 2023 guidelines, and many IE-causing pathogens are either not clearly defined. Moreover, an improved understanding of the relationship between bacterial species and the risk for IE has not been implemented. The guidelines give detailed and, in our view, incorrect instructions about diagnostic testing in blood culture-negative IE without presenting proper evidence. Other important diagnostic aspects, such as the value of repeated blood cultures and incubation time for blood cultures, are not discussed. We believe that a multidisciplinary collaboration that include microbiologists would have improved these guidelines, and we hope for a future harmonization of diagnostic criteria for IE.
摘要:
ESC2023年心内膜炎管理指南强调,需要多学科方法来管理感染性心内膜炎(IE)患者。我们认为,该指南不包括现代微生物学的相关观点。在ESC2023指南中更改了IE的诊断标准,许多引起IE的病原体没有明确定义或甚至没有提及。此外,对细菌种类与IE风险之间关系的更好理解尚未实施。指南给出了详细的,在我们看来是不正确的,关于在没有提供适当证据的情况下对血培养阴性IE进行诊断测试的说明。没有讨论其他重要的诊断方面,例如重复血液培养的价值和血液培养的孵育时间。我们认为,多学科合作,包括微生物学家,会改进这些指南,我们希望将来统一IE的诊断标准。