Cardiology in the young · 2025
Drug treatment analysis of infective endocarditis in children-a retrospective, single-centre study.
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Li Sanni, Meng Yan, Zhang Nan, Zhang Guying
Аннотация
OBJECTIVE: A retrospective analysis of paediatric infective endocarditis characterised causative pathogens, antimicrobial susceptibility patterns, and treatment outcomes to guide clinical decision-making.
METHODS: The data of patients who received infective endocarditis between 2016 and 2023 were retrospectively collected from the medical records database. The clinical characteristics, treatment plans, and pharmaceutical monitoring characteristics were analysed and summarised.
RESULTS: A total of 12 paediatric infective endocarditis cases were identified. Bacterial isolates included 27 Gram-positive and 1 Gram-negative strains. The most common pathogen was Staphylococcus aureus (n = 13), all methicillin-resistant Staphylococcus aureus (MRSA), followed by Abiotrophia defectiva (n = 6), Streptococcus mitis (n = 5), Streptococcus sanguinis (n = 2), Bacillus cereus (n = 1), and Klebsiella oxytoca (n = 1). Antimicrobial therapy primarily involved linezolid, vancomycin, and cephalosporin/enzyme inhibitor combinations. Cardiac glycosides were used in 10 cases, and all patients received phosphocreatine to support myocardial energy metabolism. Therapeutic drug monitoring for vancomycin was performed in 25% of cases, while no therapeutic drug monitoring was conducted for meropenem or linezolid.
CONCLUSION: All the causative organisms were predominantly Gram-positive cocci, with MRSA accounting for the largest proportion; different streptococci varied considerably in terms of drug resistance. The antimicrobial drugs used were predominantly linezolid and glycopeptides. The rate of blood concentration monitoring was low.
METHODS: The data of patients who received infective endocarditis between 2016 and 2023 were retrospectively collected from the medical records database. The clinical characteristics, treatment plans, and pharmaceutical monitoring characteristics were analysed and summarised.
RESULTS: A total of 12 paediatric infective endocarditis cases were identified. Bacterial isolates included 27 Gram-positive and 1 Gram-negative strains. The most common pathogen was Staphylococcus aureus (n = 13), all methicillin-resistant Staphylococcus aureus (MRSA), followed by Abiotrophia defectiva (n = 6), Streptococcus mitis (n = 5), Streptococcus sanguinis (n = 2), Bacillus cereus (n = 1), and Klebsiella oxytoca (n = 1). Antimicrobial therapy primarily involved linezolid, vancomycin, and cephalosporin/enzyme inhibitor combinations. Cardiac glycosides were used in 10 cases, and all patients received phosphocreatine to support myocardial energy metabolism. Therapeutic drug monitoring for vancomycin was performed in 25% of cases, while no therapeutic drug monitoring was conducted for meropenem or linezolid.
CONCLUSION: All the causative organisms were predominantly Gram-positive cocci, with MRSA accounting for the largest proportion; different streptococci varied considerably in terms of drug resistance. The antimicrobial drugs used were predominantly linezolid and glycopeptides. The rate of blood concentration monitoring was low.