UNASSIGNED: We conducted a retrospective observational study in a French IE referral center (Paris). All patients with IE who received SAT between 2016 and 2022 were included.
UNASSIGNED: Forty-two patients were included (36 male [86%]; median age [interquartile range {IQR}], 73 [61-82] years). The median Charlson Comorbidity Index score (IQR) was 3 (1-4). Forty patients (95%) had an intracardiac device. The most frequent microorganisms were Enterococcus faecalis (15/42, 36%) and Staphylococcus aureus (12/42, 29%). SAT indications were absence of surgery despite clinical indication (28/42, 67%), incomplete removal of prosthetic material (6/42, 14%), uncontrolled infection source (4/42, 10%), persistent abnormal uptake on nuclear imaging (1/42, 2%), or a combination of the previous indications (3/42, 7%). Antimicrobials were mainly doxycycline (19/42, 45%) and amoxicillin (19/42, 45%). The median follow-up time (IQR) was 398 (194-663) days. Five patients (12%) experienced drug adverse events. Five patients (12%) presented with a second IE episode during follow-up, including 2 reinfections (different bacterial species) and 3 possible relapses (same bacterial species). Fourteen patients (33%) in our cohort died during follow-up. Overall, the 1-year survival rate was 84.3% (73.5%-96.7%), and the 1-year survival rate without recurrence was 74.1% (61.4%-89.4%).
UNASSIGNED: SAT was mainly prescribed to patients with cardiac devices because of the absence of surgery despite clinical indication. Five (12%) breakthrough second IE episodes were reported. Prospective comparative studies are required to guide this empirical practice.
■我们在法国IE转诊中心(巴黎)进行了一项回顾性观察研究。纳入2016年至2022年期间接受SAT的所有IE患者。
■纳入42例患者(36例男性[86%];中位年龄[四分位距{IQR}],73[61-82]年)。中位Charlson合并症指数评分(IQR)为3(1-4)。40名患者(95%)有心脏内装置。最常见的微生物是粪肠球菌(15/42,36%)和金黄色葡萄球菌(12/42,29%)。尽管有临床指征,但SAT指征是没有手术(28/42,67%),假体材料去除不完全(6/42,14%),不受控制的感染源(4/42,10%),核成像持续异常摄取(1/42,2%),或先前适应症的组合(3/42,7%)。抗菌药物主要为强力霉素(19/42,45%)和阿莫西林(19/42,45%)。中位随访时间(IQR)为398(194-663)天。5例患者(12%)出现药物不良事件。五名患者(12%)在随访期间出现第二次IE发作,包括2次再感染(不同的细菌种类)和3次可能的复发(相同的细菌种类)。我们队列中有14名患者(33%)在随访期间死亡。总的来说,1年生存率为84.3%(73.5%-96.7%),无复发的1年生存率为74.1%(61.4%~89.4%)。
■SAT主要用于心脏装置患者,因为尽管有临床指征,但没有手术。报告了五次(12%)突破性的第二次IE发作。需要前瞻性的比较研究来指导这种经验实践。