产NDM耐碳青霉烯酶的肺炎克雷伯杆菌引起的人工瓣膜感染性心内膜炎1例
A Case of Prosthetic Valve Infective Endocarditis Caused by NDM Carbapenemase-Producing Klebsiella pneumoniae
DOI: 10.12677/acm.2026.162539, PDF,   
作者: 沈思佳, 李兰娟*：浙江大学医学院附属第一医院，传染病诊治国家重点实验室，浙江 杭州；魏茹楠：浙江树人学院树兰国际医学院附属树兰杭州医院感染科，全省人工器官与计算医学重点实验室，浙江 杭州
关键词: 感染性心内膜炎；人工瓣膜置换；多重耐药菌；Infective Endocarditis； Prosthetic Valve Replacement； Multidrug-Resistant Bacteria
摘要: 产新德里金属β-内酰胺酶的肺炎克雷伯菌(New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae, NDM-KP)是肠杆菌科克雷伯菌属中一种对多种抗生素耐药的泛耐药菌株，其感染后临床病死率显著升高。本病例为首例公开报道的NDM-KP引起的早期人工瓣膜感染性心内膜炎(Prosthetic Valve Endocarditis, PVE)成功救治案例。该患者经多次心脏超声检查均未发现典型瓣膜感染征象，最终通过PET-CT确诊。经6周针对性抗感染治疗后，患者临床治愈。本案例旨在提升临床医师对NDM-KP相关PVE的早期识别能力，减少误诊和漏诊风险。
Abstract: New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae (NDM-KP) is a pan-drug-resistant strain within the Enterobacteriaceae family, with significantly elevated clinical mortality rates upon infection. This case represents the first publicly reported instance of NDM-KP-induced early prosthetic valve endocarditis (PVE) successfully treated. The patient underwent multiple transthoracic echocardiographic examinations that initially failed to reveal typical valve infection signs, with final diagnosis confirmed by PET-CT. After six weeks of targeted antibiotic therapy, the patient achieved clinical cure. This case aims to enhance clinicians’ early recognition of NDM-KP-related PVE, thereby reducing risks of misdiagnosis and missed diagnosis.
文章引用：沈思佳, 魏茹楠, 李兰娟. 产NDM耐碳青霉烯酶的肺炎克雷伯杆菌引起的人工瓣膜感染性心内膜炎1例[J]. 临床医学进展, 2026, 16(2): 1508-1513. https://doi.org/10.12677/acm.2026.162539

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