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目的探讨感染性心内膜炎血培养阳性患者的临床诊治特点,以指导临床预防及控制疾病。方法 50例感染性心内膜炎患者,按照患者血培养结果分为实验组(20例,阳性结果)和对照组(30例,阴性结果)。分析实验组患者的血培养中病原菌分布以及革兰阳性菌耐药性情况,并比较两组发生肾功能不全、脏器出现栓塞及先天性心脏病情况。结果实验组患者出现肾功能不全6例(30.0%),脏器出现栓塞6例(30.0%),对照组患者出现肾功能不全1例(3.3%),脏器出现栓塞1例(3.3%),比较差异具有统计学意义(P<0.05)。两组均以先天性心脏病为主,各发生5例,比较差异无统计学意义(P>0.05)。实验组中主要出现的病原菌有酿脓链球菌、金黄色葡萄球菌、粪肠球菌等,对红霉素、青霉素、克林霉素均有较高的耐药性。结论感染性心内膜炎血培养阳性的临床表现没有特异性,实行实验室的检验可以有效分辨血培养阳性的病原菌分布,从而确定病情。
Objective To investigate the clinical diagnosis and treatment of infective endocarditis positive blood culture patients to guide clinical prevention and control of disease. Methods 50 patients with infective endocarditis were divided into experimental group (20 cases, positive result) and control group (30 cases, negative result) according to their blood culture results. The distribution of pathogenic bacteria in blood culture and the drug resistance of Gram-positive bacteria in the experimental group were analyzed. The renal insufficiency and organ embolism and congenital heart disease were compared between the two groups. Results In the experimental group, 6 cases (30.0%) had renal insufficiency, 6 cases (30.0%) had organ embolism, 1 case (3.3%) had renal insufficiency, and 1 case (3.3% , The difference was statistically significant (P <0.05). The two groups were mainly congenital heart disease, each occurred in 5 cases, the difference was not statistically significant (P> 0.05). The main pathogens in the experimental group were Streptococcus pyogenes, Staphylococcus aureus, Enterococcus faecalis and so on, to erythromycin, penicillin, clindamycin have higher resistance. Conclusion The positive clinical manifestations of infective endocarditis blood culture is not specific, the implementation of laboratory tests can effectively distinguish the distribution of blood culture-positive pathogens to determine the condition.