Kawahira T, Wakita N, Nohara H, Shida T
Kobe Rousai Hospital, Japan.
Kyobu Geka. 1996 Jul;49(8 Suppl):680-3.
We report a case of successful mitral valve replacement performed on the patient who is an infective endocarditis due to MRSA. She was 27-year-old female and treated by antibiotics medication because of remittent fever two years ago. On August 1995, cerebral infarction occurred and she was pointed out endocarditis. After high fever continued, blood cultures demonstrated MRSA. Furthermore, echocardiography showed vegetation on posterior mitral valve leaflet and moderate mitral regurgitation so, mitral valve replacement with a S.J.M. 25 mm performed to control MRSA sepsis condition. During operation, we used VCM 2 g into the extracorporeal circulation and after operation 0.5 g intravenously every 6 hours. Two weeks later we changed antibiotics to FOM, Viccillin and ABK according to the result of minimum inhibitory concentration (MIC) obtained through blood culture. The patient was discharged on the 44 th postoperative day because of her uneventful postoperative course.
我们报告了一例对因耐甲氧西林金黄色葡萄球菌(MRSA)导致感染性心内膜炎的患者成功进行二尖瓣置换术的病例。她是一名27岁女性,两年前因弛张热接受抗生素治疗。1995年8月,发生脑梗死,她被诊断为心内膜炎。持续高热后,血培养显示为MRSA。此外,超声心动图显示二尖瓣后叶有赘生物和中度二尖瓣反流,因此,为控制MRSA败血症病情,采用25毫米的圣犹达医疗公司(S.J.M.)人工瓣膜进行二尖瓣置换术。手术期间,我们在体外循环中使用了2克万古霉素,术后每6小时静脉注射0.5克。两周后,根据血培养获得的最低抑菌浓度(MIC)结果,我们将抗生素更换为夫西地酸、苯唑西林和氨基糖苷类抗生素。由于术后过程平稳,患者在术后第44天出院。