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Erschienen in: Wiener klinische Wochenschrift Education 1-2/2015

01.06.2015

Infektiöse Endokarditis – Epidemiologie, Diagnostik und Therapie

verfasst von: Jürgen Prattes, Ines Zollner-Schwetz

Erschienen in: Wiener klinische Wochenschrift Education | Ausgabe 1-2/2015

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Auszug

Der Begriff infektiöse Endokarditis (IE) bezeichnet eine durch Mikroorganismen verursachte Infektion des Endokards. Zwar können solche Infektionen prinzipiell überall am Endokard auftreten, doch sind die Herzklappen, bevorzugt die linksventrikulären Herzklappen, am häufigsten betroffen. Trotz beachtlicher Fortschritte in den diagnostischen Möglichkeiten sowie im Bereich der antimikrobiellen Therapie konnte in den letzten 30 Jahren weder ein Rückgang der Inzidenz, noch der Mortalität der IE beobachtet werden [1]. Die Mortalität der IE liegt zwischen 9,6 und 26 %, abhängig von Risikofaktoren der Patienten/innen, Komplikationen der IE, dem echokardiographischem Befund, sowie dem auslösenden Mikroorganismus. So sind im speziellen IE verursacht durch Staphylokokkus aureus (S. aureus) sowie durch Pilze mit besonders hohen Mortalitätsraten und schlechter Prognose vergesellschaftet.
Die IE hat eine Mortalität zwischen 9,6 und 26 %.
Fußnoten
1
Health care-associated IE: Auftreten von Symptomen einer IE > 48 Stunden nach Aufnahme in ein Krankenhaus, oder innerhalb der ersten 48 h nach Aufnahme wenn zuvor enger Kontakt mit Gesundheitseinrichtungen wie Dialysezentren, Ambulatorien oder Heimpflege bestand.
 
2
Community-acquired IE: Auftreten von Symptomen einer IE < 48 nach Aufnahme in ein Krankenhaus und wenn die Kriterien einer health care-associated IE nicht erfüllt sind.
 
3
nicht schmerzhafte, hämorrhagische Läsionen im Bereich der Handflächen/Fußsohlen.
 
4
etwa linsengroße, schmerzhafte, rötliche Knötchen im Bereich der Finger und Zehen.
 
5
Retinablutungen verursacht durch Immunkomplex-Vaskulitiden.
 
Literatur
2.
Zurück zum Zitat Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169(5):463–73.PubMedCentralCrossRefPubMed Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169(5):463–73.PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Benito N, Miro JM, de Lazzari E, Cabell CH, del Rio A, Altclas J, et al. Health care-associated native valve endocarditis: importance of non-nosocomial acquisition. Ann Intern Med. 2009;150(9):586–94.PubMedCentralCrossRefPubMed Benito N, Miro JM, de Lazzari E, Cabell CH, del Rio A, Altclas J, et al. Health care-associated native valve endocarditis: importance of non-nosocomial acquisition. Ann Intern Med. 2009;150(9):586–94.PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Letaief A, Boughzala E, Kaabia N, Ernez S, Abid F, Ben Chaabane T, et al. Epidemiology of infective endocarditis in Tunisia: a 10-year multicenter retrospective study. Int J Infect Dis. 2007;11(5):430–3.CrossRefPubMed Letaief A, Boughzala E, Kaabia N, Ernez S, Abid F, Ben Chaabane T, et al. Epidemiology of infective endocarditis in Tunisia: a 10-year multicenter retrospective study. Int J Infect Dis. 2007;11(5):430–3.CrossRefPubMed
6.
Zurück zum Zitat Frontera JA, Gradon JD. Right-side endocarditis in injection drug users: review of proposed mechanisms of pathogenesis. Clin Infect Dis. 2000;30(2):3740i. Frontera JA, Gradon JD. Right-side endocarditis in injection drug users: review of proposed mechanisms of pathogenesis. Clin Infect Dis. 2000;30(2):3740i.
7.
Zurück zum Zitat Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30(19):2369–413.CrossRefPubMed Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30(19):2369–413.CrossRefPubMed
8.
Zurück zum Zitat Mandell GL, Benett JE, Dolin R. Endocarditis and Intravascular Infections. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Natasha Andjelkovic; 2010. Mandell GL, Benett JE, Dolin R. Endocarditis and Intravascular Infections. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Natasha Andjelkovic; 2010.
9.
Zurück zum Zitat Everett ED, Hirschmann JV. Transient bacteremia and endocarditis prophylaxis. A review. Medicine. 1977;56(1):61–77.CrossRefPubMed Everett ED, Hirschmann JV. Transient bacteremia and endocarditis prophylaxis. A review. Medicine. 1977;56(1):61–77.CrossRefPubMed
10.
Zurück zum Zitat Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, et al. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA. 2005;293(24):3012–21.CrossRefPubMed Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, et al. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA. 2005;293(24):3012–21.CrossRefPubMed
11.
Zurück zum Zitat Chang FY, MacDonald BB, Peacock JE Jr, Musher DM, Triplett P, Mylotte JM, et al. A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance. Medicine. 2003;82(5):322–32.CrossRefPubMed Chang FY, MacDonald BB, Peacock JE Jr, Musher DM, Triplett P, Mylotte JM, et al. A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance. Medicine. 2003;82(5):322–32.CrossRefPubMed
12.
Zurück zum Zitat Chirouze C, Athan E, Alla F, Chu VH, Ralph Corey G, Selton-Suty C, et al. Enterococcal endocarditis in the beginning of the 21st century: analysis from the International Collaboration on Endocarditis-Prospective Cohort Study. Clin Microbiol Infect. 2013;19(12):1140ic. Chirouze C, Athan E, Alla F, Chu VH, Ralph Corey G, Selton-Suty C, et al. Enterococcal endocarditis in the beginning of the 21st century: analysis from the International Collaboration on Endocarditis-Prospective Cohort Study. Clin Microbiol Infect. 2013;19(12):1140ic.
13.
Zurück zum Zitat Arias CA, Murray BE. Emergence and management of drug-resistant enterococcal infections. Expert Rev Anti Infect Ther. 2008;6(5):6378rt. Arias CA, Murray BE. Emergence and management of drug-resistant enterococcal infections. Expert Rev Anti Infect Ther. 2008;6(5):6378rt.
14.
Zurück zum Zitat Orsi GB, Ciorba V. Vancomycin resistant enterococci healthcare associated infections. Ann Ig. 2013;25(6):485–92.PubMed Orsi GB, Ciorba V. Vancomycin resistant enterococci healthcare associated infections. Ann Ig. 2013;25(6):485–92.PubMed
15.
Zurück zum Zitat Chambers ST, Murdoch D, Morris A, Holland D, Pappas P, Almela M, et al. HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. PLoS One. 2013;8(5):e63181.PubMedCentralCrossRefPubMed Chambers ST, Murdoch D, Morris A, Holland D, Pappas P, Almela M, et al. HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. PLoS One. 2013;8(5):e63181.PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Ellis ME, Al-Abdely H, Sandridge A, Greer W, Ventura W. Fungal endocarditis: evidence in the world literature, 1965from . Clin Infect Dis. 2001;32(1):5001i. Ellis ME, Al-Abdely H, Sandridge A, Greer W, Ventura W. Fungal endocarditis: evidence in the world literature, 1965from . Clin Infect Dis. 2001;32(1):5001i.
19.
Zurück zum Zitat Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):6330i. Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):6330i.
20.
Zurück zum Zitat Hoen B, Beguinot I, Rabaud C, Jaussaud R, Selton-Suty C, May T, et al. The Duke criteria for diagnosing infective endocarditis are specific: analysis of 100 patients with acute fever or fever of unknown origin. Clin Infect Dis. 1996;23(2):2986ica. Hoen B, Beguinot I, Rabaud C, Jaussaud R, Selton-Suty C, May T, et al. The Duke criteria for diagnosing infective endocarditis are specific: analysis of 100 patients with acute fever or fever of unknown origin. Clin Infect Dis. 1996;23(2):2986ica.
21.
Zurück zum Zitat Dodds GA, Sexton DJ, Durack DT, Bashore TM, Corey GR, Kisslo J. Negative predictive value of the Duke criteria for infective endocarditis. Am J Cardiol. 1996;77(5):403–7.CrossRefPubMed Dodds GA, Sexton DJ, Durack DT, Bashore TM, Corey GR, Kisslo J. Negative predictive value of the Duke criteria for infective endocarditis. Am J Cardiol. 1996;77(5):403–7.CrossRefPubMed
22.
Zurück zum Zitat Gilbert DNM RC, Eliopoulos GM, Chambers HF, Saag MS. The Sanford Guide To Antimicrobial Therapy 2013. 43rd ed. Sperryville: Antimicrobial Therapy, Inc.; 2013. Gilbert DNM RC, Eliopoulos GM, Chambers HF, Saag MS. The Sanford Guide To Antimicrobial Therapy 2013. 43rd ed. Sperryville: Antimicrobial Therapy, Inc.; 2013.
23.
Zurück zum Zitat Stryjewski ME, Szczech LA, Benjamin DK Jr, Inrig JK, Kanafani ZA, Engemann JJ, et al. Use of vancomycin or first-generation cephalosporins for the treatment of hemodialysis-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia. Clin Infect Dis. 2007;44(2):1907i. Stryjewski ME, Szczech LA, Benjamin DK Jr, Inrig JK, Kanafani ZA, Engemann JJ, et al. Use of vancomycin or first-generation cephalosporins for the treatment of hemodialysis-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia. Clin Infect Dis. 2007;44(2):1907i.
24.
Zurück zum Zitat Cosgrove SE, Vigliani GA, Fowler VG, Jr., Abrutyn E, Corey GR, Levine DP, et al. Initial low-dose gentamicin for Staphylococcus aureus bacteremia and endocarditis is nephrotoxic. Clin Infect Dis. 2009;48(6):7139ic. Cosgrove SE, Vigliani GA, Fowler VG, Jr., Abrutyn E, Corey GR, Levine DP, et al. Initial low-dose gentamicin for Staphylococcus aureus bacteremia and endocarditis is nephrotoxic. Clin Infect Dis. 2009;48(6):7139ic.
25.
Zurück zum Zitat Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52(3):2851ic. Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clin Infect Dis. 2011;52(3):2851ic.
26.
Zurück zum Zitat Gould IM, Miro JM, Rybak MJ. Daptomycin: the role of high-dose and combination therapy for Gram-positive infections. Int J Antimicrob Agents. 2013;42(3):202–10.CrossRefPubMed Gould IM, Miro JM, Rybak MJ. Daptomycin: the role of high-dose and combination therapy for Gram-positive infections. Int J Antimicrob Agents. 2013;42(3):202–10.CrossRefPubMed
27.
Zurück zum Zitat Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. 2005;111(23):e394–434.CrossRefPubMed Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. 2005;111(23):e394–434.CrossRefPubMed
28.
Zurück zum Zitat Reynolds R, Potz N, Colman M, Williams A, Livermore D, MacGowan A, et al. Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001–2002: the BSAC Bacteraemia Resistance Surveillance Programme. J Antimicrob Chemother. 2004;53(6):1018–32.CrossRefPubMed Reynolds R, Potz N, Colman M, Williams A, Livermore D, MacGowan A, et al. Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001–2002: the BSAC Bacteraemia Resistance Surveillance Programme. J Antimicrob Chemother. 2004;53(6):1018–32.CrossRefPubMed
30.
Zurück zum Zitat Pericas JM, Cervera C, del Rio A, Moreno A, Garcia de la Maria C, Almela M, et al. Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone. Clin Microbiol Infect. 2014;20(12):O1075cal. Pericas JM, Cervera C, del Rio A, Moreno A, Garcia de la Maria C, Almela M, et al. Changes in the treatment of Enterococcus faecalis infective endocarditis in Spain in the last 15 years: from ampicillin plus gentamicin to ampicillin plus ceftriaxone. Clin Microbiol Infect. 2014;20(12):O1075cal.
31.
Zurück zum Zitat Lye DC, Hughes A, O'Brien D, Athan E. Candida glabrata prosthetic valve endocarditis treated successfully with fluconazole plus caspofungin without surgery: a case report and literature review. Eur J Clin Microbiol Infect Dis. 2005;24(11):753–5.CrossRefPubMed Lye DC, Hughes A, O'Brien D, Athan E. Candida glabrata prosthetic valve endocarditis treated successfully with fluconazole plus caspofungin without surgery: a case report and literature review. Eur J Clin Microbiol Infect Dis. 2005;24(11):753–5.CrossRefPubMed
32.
Zurück zum Zitat Garzoni C, Nobre VA, Garbino J. Candida parapsilosis endocarditis: a comparative review of the literature. Eur J Clin Microbiol Infect Dis. 2007;26(12):915–26.CrossRefPubMed Garzoni C, Nobre VA, Garbino J. Candida parapsilosis endocarditis: a comparative review of the literature. Eur J Clin Microbiol Infect Dis. 2007;26(12):915–26.CrossRefPubMed
Metadaten
Titel
Infektiöse Endokarditis – Epidemiologie, Diagnostik und Therapie
verfasst von
Jürgen Prattes
Ines Zollner-Schwetz
Publikationsdatum
01.06.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift Education / Ausgabe 1-2/2015
Print ISSN: 1863-3579
Elektronische ISSN: 1863-3765
DOI
https://doi.org/10.1007/s11812-015-0071-8