感染性心内膜炎与糖尿病的关系——患者特征、微生物病因学和死亡率。

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-09-10 DOI:10.1007/s15010-025-02624-7

Andreas Dalsgaard Jensen, Lauge Østergaard, Peter Laursen Graversen, Katra Hadji-Turdeghal, Jeppe K Petersen, Peter Rossing, Christian Selmer, Jonas Agerlund Povlsen, Marianne Voldstedlund, Henning Bundgaard, Claus Moser, Emil Loldrup Fosbøl

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引用次数: 0

摘要

目的：感染性心内膜炎（IE）合并糖尿病（DM）会导致严重的后果。我们的目的是报道一个全国性队列中按糖尿病分层的IE患者的特征、微生物病因学和死亡率。方法：我们使用丹麦的注册表，首次IE患者（2010-2020）按DM分层。我们计算了入院后一年死亡率的逆Kaplan-Meier估计值。我们对入院和出院后的1年死亡率进行了多变量校正Cox回归。结果：我们确定了6211例首次IE患者；1503例（24.2%）糖尿病患者（26.1%为1型糖尿病，68.1%为男性，中位年龄72.7岁）；4708例（75.8%）未患糖尿病（67.0%为男性，中位年龄72.4岁）。IE和DM患者患慢性肾脏疾病的比例更高（35.9%比11.1%）。IE合并DM患者以金黄色葡萄球菌（S. aureus）为主（36.5%），非DM患者以链球菌（spp.）为主（29.4%）。IE和DM患者与入院后一年死亡率增加相关（41.1% [95% CI: 38.5%-43.6%]对31.0% [95% CI: 29.6%-32.3%]）。与非糖尿病患者相比，IE和糖尿病患者入院1年后（HR = 1.15 [95% CI: 1.04-1.27]）和出院1年后（HR = 1.26 [95% CI: 1.09-1.46]）的调整死亡率估计更高。结论：IE和DM患者的肾脏疾病负担较高，金黄色葡萄球菌为主要微生物，入院和出院时一年死亡率均增加。这些发现呼吁改善糖尿病患者IE的管理。

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Infective endocarditis and relationship with diabetes mellitus - Patient characteristics, microbial etiology and mortality.

Purpose: Infective endocarditis (IE) has been associated with severe outcomes when complicated by diabetes mellitus (DM). We aimed to report characteristics, microbial etiology, and mortality for patients with IE stratified by DM from a nationwide cohort.

Methods: We used Danish registries, and patients with first-time IE (2010-2020) were stratified by DM. We computed inverse Kaplan-Meier estimates for one-year mortality from admission. We computed multivariable adjusted Cox regression for the adjusted one-year mortality from admission and discharge.

Results: We identified 6,211 patients with first-time IE; 1,503 (24.2%) with DM (26.1% Type 1 DM, 68.1% male, median age 72.7 years); 4,708 (75.8%) did not have DM (67.0% male, median age 72.4 years). Patients with IE and DM had a higher proportion of chronic kidney disease (35.9% vs. 11.1%). The most predominant microorganism was Staphylococcus aureus (S. aureus) for patient with IE and DM (36.5%), and Streptococcus species (spp.) for those without DM (29.4%). Patients with IE and DM were associated with an increased one-year mortality from admission (41.1% [95% CI: 38.5%-43.6%] vs. 31.0% [95% CI: 29.6%-32.3%]). The adjusted mortality estimates were higher for patients with IE and DM compared to those without DM one year from admission (HR = 1.15 [95% CI: 1.04-1.27]), and one year from discharge (HR = 1.26 [95% CI: 1.09-1.46]).

Conclusion: Patients with IE and DM were associated with a higher burden of kidney disease, S. aureus as the predominant microorganism, and increased one-year mortality both from admission and discharge. These findings call for improved management of IE in patients with DM.

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.