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Abstract：
Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (LSIE) and exhibits distinct epidemiological, clinical, and microbiological characteristics. Previous studies have focused primarily on RSIE in patients with intravenous drug use. We investigated the characteristics and risk factors for RSIE in an area where intravenous drug use is uncommon. A retrospective cohort study was conducted at a tertiary hospital in South Korea. Patients diagnosed with infective endocarditis between November 2005 and August 2017 were categorized into LSIE and RSIE groups. Of the 406 patients, 365 (89.9%) had LSIE and 41 (10.1%) had RSIE. The mortality rates were 31.7% in the RSIE group and 31.5% in the LSIE group (P = 0.860). Patients with RSIE had a higher prevalence of infection with Staphylococcus aureus (29.3% vs. 13.7%, P = 0.016), coagulase-negative staphylococci (17.1% vs. 6.0%, P = 0.022), and gram-negative bacilli other than HACEK (12.2% vs. 2.2%, P = 0.003). Younger age (adjusted odds ratio [aOR] 0.97, 95% confidence interval [CI] 0.95-0.99, P = 0.006), implanted cardiac devices (aOR 37.75, 95% CI 11.63-141.64, P ≤ 0.001), and central venous catheterization (aOR 4.25, 95% CI 1.14-15.55, P = 0.029) were independent risk factors for RSIE. Treatment strategies that consider the epidemiologic and microbiologic characteristics of RSIE are warranted.
摘要：
右侧感染性心内膜炎（RSIE）不如左侧感染性心内膜炎（LSIE）常见，并表现出明显的流行病学特征。临床,和微生物学特征。以前的研究主要集中在静脉用药患者的RSIE。我们调查了在静脉吸毒不常见的地区RSIE的特征和危险因素。在韩国一家三级医院进行了一项回顾性队列研究。在2005年11月至2017年8月期间诊断为感染性心内膜炎的患者分为LSIE和RSIE组。406名患者中,365（89.9％）患有LSIE，41（10.1％）患有RSIE。RSIE组和LSIE组的死亡率分别为31.7%和31.5%(P=0.860)。RSIE患者金黄色葡萄球菌感染率较高(29.3%vs.13.7%,P=0.016),凝固酶阴性葡萄球菌（17.1%vs.6.0%，P=0.022),和HACEK以外的革兰氏阴性杆菌（12.2%vs.2.2%,P=0.003)。年龄较小（调整后的比值比[aOR]0.97，95%置信区间[CI]0.95-0.99，P=0.006），植入式心脏装置(aOR37.75,95%CI11.63-141.64,P≤0.001),中心静脉置管（aOR4.25，95％CI1.14-15.55，P=0.029）是RSIE的独立危险因素。考虑RSIE的流行病学和微生物学特征的治疗策略是必要的。
