中国药房2017，Vol.28Issue(29)：4076-4080,5.DOI:10.6039/j.issn.1001-0408.2017.29.12
我院162例感染性心内膜炎患者的临床和病原学特征分析
Analysis of Clinical and Pathogenic Characteristics of 162 Patients with Infective Endocarditis in Our Hos-pital
摘要
Abstract
OBJECTIVE:To provide reference for rational use of antibiotics in clinic. METHODS:A total of 162 inpatients with infective endocarditis(IE)selected from our hospital during Jan. 2014-Jun. 2016 were analyzed retrospectively in respects of general information of patients,distribution of neoplasm,clinical manifestations,examination indexes,sample type,pathogenic composition,drug resistance,treatment and outcome. RESULTS:Among 162 IE patients,the ratio of male to female was 1.9:1, and the age of patients were mainly 41-60 years old.Totally 146 patients suffered from cardiac basic disease(90.1%). One hundred and forty-five patients suffered from positive neoplasm,which mainly involved left ventricular system. Aortic valve neoplasm was the most common(59 cases,40.7%). One hundred and thirty patients suffered from fever.Among them,white blood cell count of 66 cases and neutrophil percentage of 104 cases were increased,while red blood cell count of 69 cases and hemoglobin of 100 cas-es were decreased. ALT of 22 cases,AST of 45 cases and serum creatinine of 16 cases were increased. Among 162 IE patients, 696 blood samples and 282 positive samples were detected(positive rate of 40.5%). Blood culture of 78 patients were positive (48.1%). Eighty-eight strains of pathogens were detected,including 84 strains of Gram-positive bacteria(95.5%,mainly being Streptococcus)and 4 strains of Gram-negative bacteria(4.5%). Resistance rate of Streptococcus to penicillin was 30.4%. Twelve strains of Staphylococcus were resistant to penicillin,and resistance rates of them to oxacillin were 50.0%. Enterococcus was resis-tant to penicillin,oxacillin and amikacin.Above bacteria were all sensitive to vancomycin,teicoplanin and linezolid,with resistant rate of 0.Among 162 IE patients,140 patients underwent cardiac surgery to clear neoplasm(86.4%),158 patients were cured or recovered,2 cases died and 2 cases were discharged from hospital voluntarily. CONCLUSIONS:In our hospital,IE patients are mainly male and suffered from cardiac basic disease. Most of the patients have cardiac neoplasm,which were mainly left cardiac neoplasm. Fever patients are the majority,accompanied by anemia,liver and kidney dysfunction and other symptoms. The patho-genic bacteria causing IE are mainly Gram-positive bacteria;Streptococcus is still the most common bacteria,and drug resistance is not optimistic. Antibiotics should be selected according to local etiological data,and medication plan should be adjusted in time according to the results of drug sensitivity test so as to guaran-tee the effectiveness and safety of anti-infection treatment.关键词
感染性心内膜炎/病原菌/抗菌药物/耐药性/临床特征/病原学特征Key words
Infective endocarditis/Pathogens/Antibiotics/Drug resistance/Clinical characteristics/Pathogenic characteristics分类
医药卫生引用本文复制引用
叶飞,张蓉,周世文..我院162例感染性心内膜炎患者的临床和病原学特征分析[J].中国药房,2017,28(29):4076-4080,5.基金项目
第三军医大学第二附属医院临床科研项目(No. 2014YLC35) （No. 2014YLC35）
