Smyth E G, Pallister D
Department of Medical Microbiology, St George's Hospital Medical School, London.
J R Soc Med. 1989 Jul;82(7):396-8. doi: 10.1177/014107688908200709.
Twenty-four patients with staphylococcal septicaemia due to permanent (14) and temporary (10) endocardial pacemakers were reviewed. With permanent pacemakers local inflammation was usually present and the onset of septicaemia rapid. If patients were treated with high dose intravenous flucloxacillin combined with removal, recovery was usual. In patients with retained endocardial tips (6) we eradicated infection with medical treatment alone in four cases. We would advocate antistaphylococcal prophylaxis for patients undergoing revision in the presence of local inflammation and high dose intravenous flucloxacillin plus a second anti-staphylococcal antibiotic (e.g. gentamicin) in patients with septicaemia and a pacemaker in situ.
对24例因永久性（14例）和临时性（10例）心内膜起搏器导致葡萄球菌败血症的患者进行了回顾性研究。对于永久性起搏器，局部炎症通常存在，败血症发病迅速。如果患者接受大剂量静脉注射氟氯西林并移除起搏器治疗，通常可康复。在保留心内膜电极尖端的患者（6例）中，4例仅通过药物治疗根除了感染。对于存在局部炎症且正在进行起搏器翻修的患者，我们建议进行抗葡萄球菌预防；对于患有败血症且起搏器仍在位的患者，建议使用大剂量静脉注射氟氯西林加第二种抗葡萄球菌抗生素（如庆大霉素）。
