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2015 AHA科学声明:成人感染性心内膜炎的诊断、抗菌治疗及并发症管理

AHA Scientific Statement 1

Background —Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today’s myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances.

Methods and Results —This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Y oung. It includes an evidenced-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations.

Conclusions —Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management. (Circulation . 2015;132:00-00. DOI: 10.1161/CIR.0000000000000296.) Key Words: AHA Scientific Statements ◼ anti-infective agents ◼ echocardiography ◼ endocarditis ◼ infection (Circulation . 2015;132:00-00. DOI: 10.1161/CIR.0000000000000296.)

© 2015 American Heart Association, Inc.

Circulation is available at http://www.doczj.com/doc/25ceb4530508763230121213.html DOI: 10.1161/CIR.0000000000000296

The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on May 12, 2015, and the American Heart Association Executive Committee on June 12, 2015. A copy of the document is available at http://www.doczj.com/doc/25ceb4530508763230121213.html /statements by selecting either the “By Topic” link or the “By Publication Date” link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@http://www.doczj.com/doc/25ceb4530508763230121213.html .The American Heart Association requests that this document be cited as follows: Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ, Barsic B, Lockhart PB, Gewitz MH, Levison ME, Bolger AF, Steckelberg JM, Baltimore RS, Fink AM, O’Gara P , Taubert KA; on behalf of the American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Y oung, Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132:XXX–XXX.Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://www.doczj.com/doc/25ceb4530508763230121213.html /statements and select the “Policies and Development” link.

Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.doczj.com/doc/25ceb4530508763230121213.html /HEARTORG/General/Copyright-Permission-Guidelines_UCM_300404_Article.jsp. A link to the “Copyright Permissions Request Form” appears on the right side of the page.Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

A Scientific Statement for Healthcare Professionals From the American Heart Association

Endorsed by the Infectious Diseases Society of America

Larry M. Baddour, MD, FAHA, Chair; Walter R. Wilson, MD; Arnold S. Bayer, MD;

Vance G. Fowler, Jr, MD, MHS; Imad M. Tleyjeh, MD, MSc;

Michael J. Rybak, PharmD, MPH; Bruno Barsic, MD, PhD; Peter B. Lockhart, DDS;

Michael H. Gewitz, MD, FAHA; Matthew E. Levison, MD; Ann F. Bolger, MD, FAHA;

James M. Steckelberg, MD; Robert S. Baltimore, MD; Anne M. Fink, PhD, RN;

Patrick O’Gara, MD, FAHA; Kathryn A. Taubert, PhD, FAHA; on behalf of the American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, Council on Clinical Cardiology, Council on Cardiovascular

Surgery and Anesthesia, and Stroke Council

I nfective endocarditis (IE) is an uncommon infectious dis-

ease with an annual
incidence ranging from 3 to 7 per

ease with an annual incidence ranging from 3 to 7 per

100 000 person-years in the most contemporary population surveys.1–3 Although relatively rare, IE continues to be char-acterized by increased morbidity and mortality and is now the third or fourth most common life-threatening infection by guest on September 16, 2015http://www.doczj.com/doc/25ceb4530508763230121213.html /

2015 AHA科学声明:成人感染性心内膜炎的诊断、抗菌治疗及并发症管理

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