Morris A, Guild I
Department of Microbiology, Green Lane Hospital, Auckland, New Zealand.
Rev Infect Dis. 1991 Sep-Oct;13(5):887-92. doi: 10.1093/clinids/13.5.887.
Five cases of endocarditis due to Corynebacterium pseudodiphtheriticum are described. Two patients died, two patients with prosthetic valve endocarditis were successfully treated with antibiotics and valve replacement, and one patient with native valve endocarditis was successfully treated with penicillin alone. We also review 12 previously reported cases of C. pseudodiphtheriticum endocarditis. In vitro susceptibilities to 15 antibiotics were determined for nine isolates. The minimum inhibitory concentrations (MICs) of penicillin, amoxicillin, cefamandole, cephalexin, and rifampicin were all less than or equal to 0.12 mg/L. The MICs of vancomycin and ciprofloxacin for all strains were less than or equal to 0.5 mg/L. Tobramycin was the most active aminoglycoside, with MICs for all strains that were less than or equal to 0.12 mg/L. On the basis of in vitro data and the results of previous reports, penicillin alone or in combination with an aminoglycoside should achieve bacteriologic cure. Vancomycin should be used in patients who are allergic to penicillin.
本文描述了5例由假白喉棒状杆菌引起的心内膜炎病例。2例患者死亡，2例人工瓣膜心内膜炎患者经抗生素治疗及瓣膜置换后成功治愈，1例天然瓣膜心内膜炎患者仅用青霉素治疗成功。我们还回顾了之前报道的12例假白喉棒状杆菌心内膜炎病例。对9株分离菌测定了其对15种抗生素的体外敏感性。青霉素、阿莫西林、头孢孟多、头孢氨苄和利福平的最低抑菌浓度（MIC）均小于或等于0.12mg/L。所有菌株对万古霉素和环丙沙星的MIC均小于或等于0.5mg/L。妥布霉素是活性最强的氨基糖苷类抗生素，所有菌株对其MIC均小于或等于0.12mg/L。根据体外数据和既往报道结果，单用青霉素或联合氨基糖苷类抗生素应能实现细菌学治愈。对青霉素过敏的患者应使用万古霉素。
