Yoshino Yusuke, Okugawa Shu, Kimura Satoshi, Makita Eiko, Seo Kazunori, Koga Ichiro, Matsunaga Naohisa, Kitazawa Takatoshi, Ota Yasuo
Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Microbiol Immunol Infect. 2015 Apr;48(2):226-8. doi: 10.1016/j.jmii.2012.07.015. Epub 2012 Sep 25.
We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours.
我们报告了一例使用美罗培南和阿米卡星长期联合治疗由对第三代和第四代头孢菌素耐药的阴沟肠杆菌引起的感染性心内膜炎的病例。耐多药革兰氏阴性杆菌，如我们研究中的阴沟肠杆菌，可能成为感染性心内膜炎的潜在病原体。我们对该病例的经验表明，对于未来因非流感嗜血杆菌、放线杆菌、心杆菌、艾肯菌、金氏菌属（HACEK组）革兰氏阴性杆菌（如我们病例中的这类杆菌）引起的感染性心内膜炎病例，长期使用β-内酰胺类和氨基糖苷类药物联合治疗可能是一种合适的治疗选择。
