凝固酶阴性葡萄球菌致感染性心内膜炎的病原学研究  

Study on pathogen of infectious endocarditis caused by coagulase-negative staphylococcus

作　　者：唐晓华[1] 陈琼[1] 郭旭光[1] 黄俊[2] 

机构地区：[1]广州医科大学附属第三医院检验科,广州510150 [2]广东省人民医院/广东省心血管病研究所心内科,广州510080

出　　处：《检验医学与临床》2015年第6期768-769,共2页Laboratory Medicine and Clinic

摘　　要：目的了解凝固酶阴性葡萄球菌(CNS)致感染性心内膜炎的临床特点及病原学情况,为临床诊治提供依据。方法回顾性分析2008年1月至2013年10月住院治疗的18例CNS致感染性心内膜炎患者的临床特点及病原学情况。结果基础病因中人工瓣膜置换术后占首位(50.0%);临床表现以发热(100.0%)最为常见;病原学显示表皮葡萄球菌15株(83.3%)、溶血葡萄球菌2株(11.1%)、人葡萄球菌1株(5.6%);耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)14株(77.8%),且呈多重耐药。12例患者治愈,5例好转出院,1例死亡。结论 CNS已成为感染性心内膜炎的重要病原菌,MRCNS检出率高且呈多重耐药,对CNS致感染性心内膜炎应合理地选择抗菌药物并予以足够疗程的抗感染治疗,有手术指征者应及时手术以改善患者预后。Objective To understand the etiology and clinical characteristics of coagulase-negative staphylococcus（CNS）caused infectious endocarditis.Methods The clinical data of 18 inpatients with CNS caused infectious endocarditis from Jan.2008 to Oct.2013 were analyzed retrospectively.Results In the basic etiology,9cases of prosthetic valve endocarditis（PVE）occupied the first position（50.0%）;fever（100.0%）was the most common clinical presentation;The etiology showed that 15strains（83.3%）of Staphycoccus epidermidis,2strains（11.1%）of Staphycoccus haemolyticus,1strain（5.6%）of staphylococcus hominis were isolated;there were 14 strains of methicillin-resistant Staphycoccus epidermidis（MRCNS）among 18 strains of CNS.The drug susceptibility test showed that MRCNS was multiple drug resistant.12 cases were cured,5cases were improved and discharged from hospital,and 1case died.Conclusion CNS has become an important pathogen causing infectious endocarditis,MRCNS has high detection rate and shows multiple drug resistance.It is necessary to reasonably choose antibacterial drugs and give the enough treatment course of anti-infection therapy,the patients with operation indications should be timely performed operation for improving the prognosis.

关 键 词：心内膜炎 凝固酶阴性葡萄球菌 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]