感染性心内膜炎194例的临床和病原学特点

目的分析血培养阳性的感染性心内膜炎(infective endocantitis,IE)患者的临床及病原学特点,为合理使用抗菌药物提供依据。方法回顾性分析武汉亚洲心脏病医院2014年1月-2018年12月收治的194例血培养阳性的IE患者病历资料,包括年龄、性别、临床表现及病原学检查结果等。结果194例血培养阳性的IE患者以男性为主(70.1%),平均年龄为40.5岁。IE合并心脏基础疾病最常见的是先天性心脏病(30.4%),临床表现最为常见的是发热(88.1%),最常见累及的部位是二尖瓣(46.4%),其次是主动脉瓣(22.7%)。血培养分离的病原菌中链球菌占比最高(63.4%),其次是葡萄球菌(19.1%)。链球菌属细菌对青霉素的耐药率小于10%。结论IE患者合并心脏基础疾病中,先天性心脏病和非风湿性心脏瓣膜病占比较风湿性心脏瓣膜病高。IE患者血培养的主要病原菌为链球菌属细菌。

Clinical and etiological characteristics of 194 cases of infective endocarditis

Objective To analyze the clinical and etiological characteristics of infective endocarditis(IE)in patients with positive blood culture and provide evidence for the rational use of antimicrobial agents.Methods The clinical data(including age,sex,clinical manifestations,and microbiological tests)were reviewed and analyzed retrospectively for 194 IE patients who were admitted to Wuhan Asian Heart Hospital from January 2014 through December 2018.Results Most(70.1%)of the 194 IE patients were males.Mean age of the patients was 40.5 years.Congenital heart disease(30.4%)was the most common underlying heart disease.Fever(88.1%)was the most common clinical manifestation.The most common site of involvement was mitral valve(46.4%),followed by aortic valve(22.7%).Streptococcus accounted for the highest proportion of pathogenic bacteria isolated by blood culture(63.4%),followed by Staphylococcus(19.1%).Less than 10% of the Streptococcus isolates were resistant to penicillin.Conclusions Congenital heart disease and non-rheumatic valvular heart disease are more common than rheumatic heart disease in IE patients.Streptococcus is the main pathogen isolated from blood culture in IE patients.