Waldvogel F A
Schweiz Med Wochenschr. 1975 Nov 1;105(44):1427-32.
The classical paper published by Schottmüller in 1903 has shown beyond doubt that blood cultures are a crucial diagnostic procedure for the diagnosis of endocarditis. Positive blood cultures also make it possible to distinguish between bacteremia and endocarditis: in the latter condition the number of organisms per ml of blood is relatively constant and all blood cultures are usually positive. Gram positive cocci are still the commonest organisms found in classical endocarditis. Gram negative organisms, yeasts and fungi are cultured with increasing frequency in cases of endocarditis secondary to valve replacement. Sensitivity testing by the disc diffusion method determines the minimal inhibitory concentration of the antibiotic towards the isolated organism. However, minimal bactericidal concentrations are of much greater prognostic value in endocarditis and should be performed routinely on the isolated organism.
1903年肖特米勒发表的经典论文毫无疑问地表明，血培养是诊断心内膜炎的关键诊断程序。阳性血培养结果还能够区分菌血症和心内膜炎：在后一种情况下，每毫升血液中的微生物数量相对恒定，并且所有血培养通常都是阳性的。革兰氏阳性球菌仍然是经典心内膜炎中最常见的微生物。在瓣膜置换后继发的心内膜炎病例中，革兰氏阴性菌、酵母和真菌的培养频率越来越高。采用纸片扩散法进行的药敏试验可确定抗生素对分离出的微生物的最低抑菌浓度。然而，最低杀菌浓度在心内膜炎中具有更大的预后价值，应对分离出的微生物常规进行此项检测。
