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持久性金黄色葡萄球菌菌血症合并心内膜炎2例,先用万古霉素治疗,有耐药性,后并用利福平,效果显著。例1 女性17个月,烧伤面积40%,合并金黄色葡萄球菌败血症,空洞性肺炎,心内膜炎,高热,白细胞增多。4周中18次血培养都有耐新青霉素I的金黄色葡萄球菌生长〔最小抑菌滴度(MIC)100μg/ml〕。在发现菌血症24天后,并用万古霉素和利福平,利福平剂量为18mg/kg/天,分3次口服。血清利福平最高浓度为7.6μg/ml。联合用药1天后,血培养转阴,症状明显改善。联合用药与万古霉素单独用药的血清抑菌、杀菌最高滴度比分别为(1:64、1∶64)与(1∶16、1∶4)。联合用药8周,血培养14
Persistent Staphylococcus aureus bacteremia with endocarditis in 2 cases, first treated with vancomycin, drug resistance, and after using rifampicin, the effect is significant. Example 1 Female 17 months, burn area 40%, with Staphylococcus aureus septicemia, pneumonitis, endocarditis, fever, leukocytosis. 18 weeks blood culture in 4 weeks resistant to new penicillin I Staphylococcus aureus growth [Minimum inhibitory concentration (MIC) 100μg / ml]. 24 days after the discovery of bacteremia and with vancomycin and rifampicin, the dose of rifampin was 18 mg / kg / day orally in 3 doses. The highest concentration of serum rifampicin was 7.6 μg / ml. After 1 day of combination therapy, blood culture became negative and the symptoms improved significantly. The highest antibacterial and bactericidal titer ratios of combined drugs and vancomycin alone were (1:64, 1:64) and (1:16, 1:4), respectively. Combined treatment for 8 weeks, blood culture 14