Mills J, Drew D
Ann Intern Med. 1976 Jan;84(1):29-35. doi: 10.7326/0003-4819-84-1-29.
From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, except that 9 of the isolates exhibited colonial variation, with each variant having different antibiotic sensitivities. Aortic or mitral valves were involved in 13 patients, and heart failure developed in 9 of these. Twelve patients had embolic episodes to brain, iliofemoral arteries, or lung. Five of 6 patients with tricuspid valvulitis were cured by antibiotics either with (1) or without excision of the valve. All 12 patients with aortic or mitral valvulitis treated medically died; 11 had unremitting sepsis. Aortic valve replacement and antibiotics were effective in 1. Gentamicin combined with either carbenicillin or chloramphenicol was the most effective treatment regimen.
1969年至1974年期间，在旧金山湾区观察到19例粘质沙雷氏菌性心内膜炎病例。17例患者为静脉吸毒者，粘质沙雷氏菌导致旧金山所有与吸毒相关的心内膜炎病例中的14%。粘质沙雷氏菌菌株无色素沉着，具有典型的抗生素敏感性，但9株分离株表现出菌落变异，每个变异株具有不同的抗生素敏感性。13例患者累及主动脉瓣或二尖瓣，其中9例发生心力衰竭。12例患者出现脑、髂股动脉或肺部栓塞事件。6例三尖瓣炎患者中有5例通过使用抗生素（1）或不切除瓣膜而治愈。接受药物治疗的12例主动脉瓣或二尖瓣炎患者全部死亡；11例有持续败血症。主动脉瓣置换术联合抗生素对1例有效。庆大霉素联合羧苄青霉素或氯霉素是最有效的治疗方案。
