Rajashekaraiah K R, Rice T, Rao V S, Marsh D, Ramakrishna B, Kallick C A
Ann Intern Med. 1980 Dec;93(6):796-801. doi: 10.7326/0003-4819-93-6-796.
We have studied 50 cases of endocarditis and 54 cases of bacteremia due to Staphylococcus aureus to ascertain the clinical significance of the newly described phenomenon of tolerance. In 32 of the patients with endocarditis and 35 of those with bacteremia strains were classified as tolerant (minimum bactericidal concentration/minimum inhibitory concentration greater than or equal to 16). Patients with endocarditis due to a tolerant strain responded less favorably than did patients with a sensitive strain. A larger number of patients with a tolerant strain had prolonged fever (58% versus 19%), a higher mean number of complications (1.6 versus 0.73), a greater number of intensive-care unit admissions (66% versus 33%), and a higher mortality (25% versus 11%). In contrast there was no difference in response to therapy in bacteremic patients without endocarditis having sensitive and tolerant strains. We conclude that infection with a tolerant organism adversely influences the outcome of staphylococcal endocarditis.
我们研究了50例心内膜炎病例和54例由金黄色葡萄球菌引起的菌血症病例，以确定新描述的耐受性现象的临床意义。在心内膜炎患者中有32例，菌血症患者中有35例，菌株被分类为耐受性（最低杀菌浓度/最低抑菌浓度大于或等于16）。由耐受性菌株引起的心内膜炎患者的反应不如敏感菌株患者有利。更多耐受性菌株患者出现发热时间延长（58%对19%），平均并发症数量更多（1.6对0.73），入住重症监护病房的人数更多（66%对33%），死亡率更高（25%对11%）。相比之下，没有心内膜炎的菌血症患者中，敏感菌株和耐受性菌株对治疗的反应没有差异。我们得出结论，感染耐受性生物体对葡萄球菌性心内膜炎的结果有不利影响。
