Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX, USA.
Curr Infect Dis Rep. 2014 Oct;16(10):431. doi: 10.1007/s11908-014-0431-z.
Enterococcus spp. are among the common pathogens causing infective endocarditis (IE). Despite major medical advances and new potent antimicrobial agents, the mortality has not significantly improved for several decades. The usual lack of bactericidal activity of penicillin or ampicillin, the toxicity from the combination of penicillin plus aminoglycosides, and the increased reports of high-level resistance to aminoglycosides have led to the exploration of other regimens for treatment of Enterococcus faecalis IE. As an example, ampicillin plus ceftriaxone is now a well-recognized regimen for this organism. However, the emerging of new drug resistances in Enterococcus faecium dramatically reduces the therapeutic alternatives for this organism in IE which continues to be an immense challenge for clinicians even with the availability of newer antimicrobial agents. This article summarizes the current treatment options for enterococcal endocarditis and reviews of recent publications on the topic.
肠球菌属是引起感染性心内膜炎(IE)的常见病原体之一。尽管在医学上取得了重大进展,并且出现了新的强效抗菌药物,但几十年来死亡率并没有显著改善。青霉素或氨苄西林通常缺乏杀菌活性,青霉素加氨基糖苷类药物联合使用会产生毒性,并且氨基糖苷类药物的高水平耐药性报告越来越多,这导致了人们探索治疗粪肠球菌 IE 的其他方案。例如,氨苄西林加头孢曲松现在是治疗这种病原体的公认方案。然而,屎肠球菌中新的耐药性的出现极大地减少了这种病原体在 IE 中的治疗选择,即使有新的抗菌药物,IE 对临床医生来说仍然是一个巨大的挑战。本文总结了肠球菌性心内膜炎的当前治疗选择,并对该主题的最新出版物进行了回顾。