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[先天性心脏缺陷患者细菌性心内膜炎的病因]

[Etiology of bacterial endocarditis in patients with congenital heart defects].

作者信息

Bukharin V A, Pronina M A, Vaĭntraub E A

出版信息

Kardiologiia. 1976 Mar;16(3):78-83.

PMID:1021636
Abstract

In 90 patients with various congenital heart diseases complicated by bacterial endocarditis multiple inoculations of the blood were practised. In 14 patients microbial cultures were planted postmortem with vegetation on the endocardium, valves and also from the thrombi in the cardiac chambers and from the spleen. In 42.3 per cent of the cases a growth of microorganisms was recorded; a relation between the frequency of the microbial growth and the severity of endocarditis could be then noted. Among the planted microorganisms it was Staphylococcus albus that prevailed and this prompted the authors to consider it to be one of the principal causative agents of bacterial endocarditis in congenital heart diseases at this time. A significant proportion of the isolated microorganisms showed low sensitivity to most antibiotics. A relative frequency of negative hemocultures may be due to the use of antibiotics, the presence of forms "fruste" and indolent of endocarditis, a great variety of causative agents (including 1-forms of the bacteria) and to localization of endocardial lesions to the right heart chambers.

摘要

对90例患有各种先天性心脏病并合并细菌性心内膜炎的患者进行了多次血液接种。14例患者在死后进行了微生物培养,取心内膜、瓣膜上的赘生物,以及心腔内血栓和脾脏的样本。42.3%的病例记录到微生物生长;由此可以注意到微生物生长频率与心内膜炎严重程度之间的关系。在所培养出的微生物中,白色葡萄球菌占主导,这促使作者认为它是此时先天性心脏病细菌性心内膜炎的主要病原体之一。相当一部分分离出的微生物对大多数抗生素敏感性较低。血培养阴性的相对频率可能归因于抗生素的使用、存在“顿挫型”和隐匿型心内膜炎、病原体种类繁多(包括细菌的L型)以及心内膜病变位于右心腔。

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