产酸克雷伯菌心内膜炎：抗菌药物管理策略与临床结局。
Serratia endocarditis: antimicrobial management strategies and clinical outcomes.
机构信息
Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Falk Medical Building, Suite 3A, Room 317, 3601 Fifth Avenue, Pittsburgh, PA 15213, USA.
Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
出版信息
J Antimicrob Chemother. 2023 Oct 3;78(10):2457-2461. doi: 10.1093/jac/dkad254.
OBJECTIVES
The incidence of Serratia endocarditis is increasing, yet optimal treatment has not been defined. Our objective was to investigate the outcomes of patients with Serratia endocarditis by treatment strategy.
METHODS
We reviewed adult patients with definitive Serratia endocarditis at two independent health systems between July 2001 and April 2023. Combination therapy was defined as receipt of ≥2 in vitro active agents for ≥72 h.
RESULTS
Seventy-five patients were included; 64% (48/75) were male and 85% (64/75) were people who inject drugs. Compared with monotherapy, receipt of combination therapy was associated with lower rates of microbiological failure (0% versus 15%, P = 0.026) and 90 day all-cause mortality (11% versus 31%, P = 0.049). Antimicrobial discontinuation due to an adverse event was more common among patients receiving combination therapy compared with monotherapy (36% versus 8%, P = 0.058).
CONCLUSIONS
In the largest series of Serratia endocarditis to date, combination antibiotic treatment was associated with improved outcomes. However, larger, prospective studies are warranted.
目的
黏质沙雷氏菌性心内膜炎的发病率正在上升，但尚未明确最佳治疗方法。本研究旨在通过治疗策略探讨黏质沙雷氏菌性心内膜炎患者的结局。
方法
我们回顾了 2001 年 7 月至 2023 年 4 月在两个独立医疗系统中确诊的成人黏质沙雷氏菌性心内膜炎患者。联合治疗定义为接受至少两种体外活性药物治疗≥72 h。
结果
共纳入 75 例患者，其中 64%（48/75）为男性，85%（64/75）为注射吸毒者。与单药治疗相比，联合治疗的微生物学失败率（0% vs. 15%，P=0.026）和 90 天全因死亡率（11% vs. 31%，P=0.049）均较低。与单药治疗相比，联合治疗组因不良反应而停止使用抗生素的患者更为常见（36% vs. 8%，P=0.058）。
结论
在迄今为止最大的黏质沙雷氏菌性心内膜炎系列研究中，联合抗生素治疗与改善结局相关。然而，仍需要更大规模的前瞻性研究。
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