| BackgroundInfective endocarditis(IE)is a kind of critical disease.Although medical technology has made great progress,the motality rate remains high.The result of drug susceptibility test is important for effective treatment of IE.However,in some cases,it is not possible to obtain the result of drug susceptibility test or because the patient is in critical condition and it is too late to wait for the drug sensitivity report,antibiotics use could only based on our experience.At this time,the epidemiological data of pathogen resistance in this area is particularly important.With the development of medicine and social progress,the pathogen of IE is also changing.Moreover,there is a difference in the epidemiology of pathogenic bacteria in each region.Therefore,it is of significance to analyze the distribution of pathogenic bacteria in patients with IE in this region and to guide the rational use of antimicrobial agents.MethodsA retrospective study was used to analyze the clinical characteristics of hospital patients with IE in Xinqiao hospital and Southwest hospital of Chongqing,from January 1,2014 to June 1,2016.The clinical characteristics include the basic conditions of IE,the distribution of the vegetations,clinical manifestation and inspection indicators,pathogen composition and drug resistance,correlation analysis of pathogen infection,treatment outcome.Results1.The average age of IE in Chongqing area is 43.8±14.6 years.The average age of male patients was 45.5±13.5 years.The average age of female patients was 40.5±16.3 years.The average age of male was higher than female and the difference was statistically significant.Male patients have higher risk of IE than female,The male to female ratio of cases was 1.98.2.Organic heart disease is a major risk factor for IE.83.5% IE patients have organic heart disease.Vegetations in left side of the heart(86.0%)is much more than right side of the heart(14.0%).3.Blood culture is the most important laboratory method to diagnose IE,but the positive rate of blood culture is only 54.7%.Blood culture results showed that gram-positive bacteria(95.7%)were significantly higher than gram-negative bacteria(4.3%).Streptococcus(75.2%)is the most common pathogen,the second was staphylococcus(15.1%)and the third was enterococcus(2.2%).The penicillin resistance rate of streptococcus is high(30.4%),but the sensitivity to cephalosporin remains high and the drug resistance rate is lower than 10%.Streptococcus is all sensitive to vancomycin.4.Blood culture positive rate is higher in patients with vegetations in right side of the heart than patients with vegetations in left side of the heart,differences between the two groups were significant(p<0.05).Blood culture positive rate is higher in patients with congenital heart disease than patients with rheumatic heart disease,differences between the two groups were significant(p<0.05).5.The average cost of hospitalization for surgical treatment group was 119617.7±36401.1 yuan.The average cost of hospitalization in the drug treatment group was 16221.3±16969.8 yuan.There was a statistically significant difference between the two groups(p<0.05).The average hospital stay for surgical treatment group was 22.8±7.8.The average hospital stay for drug treatment group was 8.7±7.7.There was a statistically significant difference between the two groups(p<0.05).ConclusionsStreptococcus is the most common pathogenic bacteria for IE patients in Chongqing area.The second was staphylococcus and the third was enterococcus,gram-negative bacteria are few.The penicillin resistance rate of streptococcus is high(30.4%),but the sensitivity to cephalosporin remains high and the drug resistance rate is lower than 10%.Streptococcus is all sensitive to vancomycin.It is necessary to be aware of the resistance rate of streptococcus to penicillin during the selection of antibiotics.It is very important to obtain the drug susceptibility test results of pathogenic bacteria through standardized blood culture. |
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