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Abstract：
OBJECTIVE: To evaluate patients with prosthetic valves who developed infective endocarditis by comparing treatment outcomes in both early- and late-onset IE episodes following prosthetic valve replacement surgery. This study sought to conduct a comprehensive assessment of the efficacy of these methodologies. The insights derived from this assessment can be utilized to enhance the quality of care for individuals with infective endocarditis who have undergone prosthetic valve replacement surgery.
RESULTS: During the period of investigation (January 2017-December 2022), 78 patients diagnosed with infective endocarditis (IE) on a prosthetic valve were admitted to the Infectious Diseases Department of the \"Dr. Carol Davila\" Central Military Emergency University Hospital in Bucharest. In 28 patients (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who received only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of the patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%) and Streptococcus mitis (10.3%). The mortality rate of patients infected with S. aureus was 29.2%, indicating the severity of this infectious agent.
CONCLUSIONS: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high.
RESULTS: During the period of investigation (January 2017-December 2022), 78 patients diagnosed with infective endocarditis (IE) on a prosthetic valve were admitted to the Infectious Diseases Department of the \"Dr. Carol Davila\" Central Military Emergency University Hospital in Bucharest. In 28 patients (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who received only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of the patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%) and Streptococcus mitis (10.3%). The mortality rate of patients infected with S. aureus was 29.2%, indicating the severity of this infectious agent.
CONCLUSIONS: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high.
摘要：
目的：通过比较人工瓣膜置换手术后早期和迟发性IE发作的治疗结果，评估发生感染性心内膜炎的人工瓣膜患者。这项研究试图对这些方法的有效性进行全面评估。此评估得出的见解可用于提高接受人工瓣膜置换手术的感染性心内膜炎患者的护理质量。
结果：在调查期间（2017年1月至2022年12月），78例被诊断为人工瓣膜感染性心内膜炎（IE）的患者被送往布加勒斯特中央军事急诊大学医院的感染科。在28例患者（35.8%）中，PVE的发作发生在手术后12个月内（早期发作），而在50例患者(64.2%)中，发病发生在手术后12个月以上(晚发病).死亡率为35.9%（早发型患者为53.6%，晚发型患者为26%）。在接受手术和药物治疗的患者中，死亡率为29.6%，而在那些只接受药物治疗的人中，报告了39.2%的死亡率.根据提取的数据，72.6%的患者使用抗生素治疗成功.相比之下,手术和基于药物的方法的组合导致76.1%的患者治愈.最常见的病原体是金黄色葡萄球菌（38.5%），其次是粪肠球菌(26.9%)和链球菌(10.3%)。金黄色葡萄球菌感染患者的死亡率为29.2%,表明这种传染因子的严重程度。
结论：人工瓣膜心内膜炎（PVE）是一种与短期和长期高死亡率相关的严重疾病。不管用什么疗法,死亡的风险仍然很高。
结果：在调查期间（2017年1月至2022年12月），78例被诊断为人工瓣膜感染性心内膜炎（IE）的患者被送往布加勒斯特中央军事急诊大学医院的感染科。在28例患者（35.8%）中，PVE的发作发生在手术后12个月内（早期发作），而在50例患者(64.2%)中，发病发生在手术后12个月以上(晚发病).死亡率为35.9%（早发型患者为53.6%，晚发型患者为26%）。在接受手术和药物治疗的患者中，死亡率为29.6%，而在那些只接受药物治疗的人中，报告了39.2%的死亡率.根据提取的数据，72.6%的患者使用抗生素治疗成功.相比之下,手术和基于药物的方法的组合导致76.1%的患者治愈.最常见的病原体是金黄色葡萄球菌（38.5%），其次是粪肠球菌(26.9%)和链球菌(10.3%)。金黄色葡萄球菌感染患者的死亡率为29.2%,表明这种传染因子的严重程度。
结论：人工瓣膜心内膜炎（PVE）是一种与短期和长期高死亡率相关的严重疾病。不管用什么疗法,死亡的风险仍然很高。
