Department of Pathology and Laboratory Medicine, Kariya Toyota General Hospital, 5-15 Sumiyoshi, Kariya, Aichi, Japan.
J Infect Chemother. 2013 Apr;19(2):321-5. doi: 10.1007/s10156-012-0465-9. Epub 2012 Sep 12.
An autopsy case of infective endocarditis caused by multidrug-resistant Streptococcus mitis was described in a patient with a combination of factors that compromised immune status, including autoimmune hemolytic anemia, post-splenectomy state, prolonged steroid treatment, and IgA deficiency. The isolated S. mitis strain from blood culture was broadly resistant to penicillin, cephalosporins, carbapenem, macrolides, and fluoroquinolone. Recurrent episodes of bacterial infections and therapeutic use of several antibiotics may underlie the development of multidrug resistance for S. mitis. Because clinically isolated S. mitis strains from chronically immunocompromised patients have become resistant to a wide spectrum of antibiotics, appropriate antibiotic regimens should be selected when treating invasive S. mitis infections in these compromised patients.
本文报道了 1 例由多重耐药性米氏链球菌引起的感染性心内膜炎的尸检病例。该患者存在多种导致免疫状态受损的因素，包括自身免疫性溶血性贫血、脾切除术后状态、长期类固醇治疗和 IgA 缺乏。从血培养中分离出的米氏链球菌对青霉素、头孢菌素、碳青霉烯类、大环内酯类和氟喹诺酮类广泛耐药。反复发作的细菌感染和多种抗生素的治疗可能导致米氏链球菌产生多重耐药性。由于慢性免疫功能低下患者分离的临床米氏链球菌菌株对广谱抗生素产生耐药性，因此在治疗这些免疫功能低下患者的侵袭性米氏链球菌感染时，应选择合适的抗生素治疗方案。
