Distribution and drug resistance of pathogens isolated from cardiac vegetations in patients with infective endocarditis

Abstract:

ObjectiveTo analyze the distribution and drug resistance of pathogens isolated from cardiac vegetations in patients with infective endocarditis(IE), so as to provide guidance for rational antimicrobial use in clinical treatment. MethodsA retrospective analysis was performed on distribution of pathogens isolated from cardiac vegetations and blood culture, as well as drug resistance of pathogens isolated from cardiac vegetations in patients with IE in a hospital form July 2012 to July 2017. ResultsThe positive rate of cardiac vegetation culture from 193 patients was 38.86%（75/193), 82 pathogenic strains were isolated from 75 patients’ cardiac vegetations, there were 58 strains(70.73%) of grampositive bacteria, 19 strains(23.17%) of gramnegative bacteria, and 5 strains (6.10%) of fungi. Grampositive bacteria were still highly sensitive to vancomycin, Streptococcus viridans had higher resistance rates to tetracycline(37.14%), clindamycin (51.43%), and erythromycin(68.57%); Staphylococcus spp. showed higher resistance rates to erythromycin(50.00%), oxacillin (60.00%), and penicillin (80.00%); resistance rates of Enterococcus spp. to levofloxacin, erythromycin, ciprofloxacin, and tetracycline were all≥75.00%; Pseudomonas spp. were highly resistant to ciprofloxacin(36.36%), levofloxacin(36.36%), and imipenem(45.45%); drug resistance rates of Ochrobactrum spp. to βlactam antibiotics were up to 100.00%; Acinetobacter spp. had high resistance rates to all detected antimicrobial agents (all>30.00%). ConclusionPathogens isolated from cardiac vegetations in patients with IE are mainly grampositive bacteria, cardiac vegetation culture can serve as an effective supplement and validation for blood culture, antimicrobial agents should be selected rationally in the clinical treatment according to antimicrobial susceptibility testing result.