Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant <italic style="font-style: italic">Staphylococcus aureus</italic> infective endocarditis

Ximeng JIANG; Donghua TIAN; Xiaoli WANG; Jinying ZHANG

doi:10.16016/j.1000-5404.201911097

您当前的位置：

首页 >

文章列表页 >

Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis

Clinical Medicine | 更新时间：2026-01-09

- Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis
- Journal of Third Military Medical University Vol. 42, Issue 7, Pages: 714-719(2020)
- 作者机构：
  
  100027 北京，武警北京总队医院内二科
- 作者简介：
- 基金信息：
  
  Supported by the General Program of National Natural Science Foundation of China(81570274)
- DOI：10.16016/j.1000-5404.201911097
  CLC： R542.41; R977.22; R978.1
- Received：12 November 2019，
  
  Revised：2019-12-03，
  
  Published：15 April 2020
- 稿件说明：
移动端阅览
Ximeng JIANG, Donghua TIAN, Xiaoli WANG, et al. Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis[J]. Journal of Third Military Medical University, 2020, 42(7): 714-719.
DOI：

Ximeng JIANG, Donghua TIAN, Xiaoli WANG, et al. Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis[J]. Journal of Third Military Medical University, 2020, 42(7): 714-719. DOI： 10.16016/j.1000-5404.201911097.

摘要

目的

观察替考拉宁联合左卡尼汀对耐甲氧西林金黄色葡萄球菌(methicillin-resistant

Staphylococcus aureus

，MRSA)感染性心内膜炎(infective endocarditis，IE)的临床疗效。

方法

选取2018年3月至2019年2月本院收治的84例MRSA所致IE患者，采用随机数字表法分为对照组(替考拉宁+安慰剂治疗)和联合用药组(替考拉宁+左卡尼汀治疗)，每组42例；观察治疗前后心功能指标变化；评估2组临床疗效及细菌清除情况；对比分析治疗前后2组血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)水平及白细胞计数(WBC)、红细胞沉降率(ESR)；观察2组治疗期间不良反应发生情况。

结果

治疗前2组心功能指标比较，差异均无统计学意义(

0.05)；治疗后联合用药组SV、CO、LVEF均显著高于对照组(

0.05)。2组临床疗效等级分布比较，差异有统计学意义(

0.05)，其中联合用药组总有效率(95.24%)显著高于对照组(80.95%

0.05)，清除率(92.86%)及总清除率(97.62%)均显著高于对照组(76.19%、83.33%

0.05)；治疗前2组血清hs-CRP、PCT水平及WBC、ESR比较，差异均无统计学意义(

0.05)；治疗后2组血清hs-CRP、PCT水平及WBC、ESR均降低，且联合用药组均显著低于对照组(

0.05)；2组总体不良反应发生率比较，差异无统计学意义(

0.05)。

结论

替考拉宁联合左卡尼汀可有效改善MRSA所致IE患者心功能，提高细菌清除率，且能有效控制感染，安全可靠。

Abstract

Objective

To observe the clinical efficacy of teicoplanin combined with levocarnitine in treatment of methicillin-resistant

Staphylococcus aureus

(MRSA) infective endocarditis (IE).

Methods

A total of 84 patients diagnosed with IE caused by MRSA admitted to our hospital from March 2018 to February 2019 were perspectively recruited

and then randomly divided into control group (teicoplanin and placebo) and combined treatment group (teicoplanin and levocarnitine)

42 cases in each group. Cardiac function indexes

including stroke output (SV)

cardiac output (CO) and left ventricular ejection fraction (LVEF) were observed before and after treatment. The clinical efficacy and bacterial clearance were evaluated and compared between the 2 groups. The levels of hypersensitivity C-reaction protein (hs-CRP) and procalcitonin (PCT)

white blood cell count (WBC)

and erythrocyte sedimentation rate (ESR) in the serum of the 2 groups before and after treatment were compared. Adverse reactions during treatment were counted and compared.

Results

There were no significant differences in cardiac function indexes between the 2 groups before treatment (

0.05). While

CO and LVEF were increased after treatment in both groups

and the above values in the combined group were significantly higher than those of the control group (

0.05). Statistical difference was seen in the distribution of efficacy grade between the 2 groups (

0.05)

and the combination group had notably higher total effective rate (95.24%

80.95%)

clearance rate (92.86%

76.19%) and total clearance rate (97.62%

83.33%) when compared with the control group (all

0.05). There were no significant differences in serum hs-CRP and PCT levels and WBC and ESR before treatment (

0.05). The indexes were decreased after treatment

with those in the combined group more significant (all

0.05). No significant difference was found in the incidence of total adverse reactions between the 2 groups (

0.05).

Conclusion

Teicoplanin combined with L-carnitine is safe and reliable

and can effectively improve the cardiac function

promote bacterial clearance rate

and effectively control infection in IE patients induced by MRSA.

关键词

Keywords

references

KRC`MÉRY V, HRICAK V, FISCHER V, et al . Etiology, risk factors and outcome of 1003 cases of infective endocarditis from a 33-year national survey in the Slovak republic: an increasing proportion of elderly patients[J ] . Neuro Endocrinol Lett, 2019, 39(8): 544-549.

NAKATANI S, OHARA T, ASHIHARA K, et al . JCS 2017 guideline on prevention and treatment of infective endocarditis[J ] .Circ J, 2019, 83(8): 1767-1809. DOI:10.1253/circj.CJ-19-0549.

FILIPPONE E J, KRAFT W K, FARBER J L. The nephrotoxicity of vancomycin[J]. Clin Pharmacol Ther, 2017, 102(3): 459-469. DOI:10.1002/cpt.726.

RAMOS-MARTÍN V, JOHNSON A, MCENTEE L, et al . Pharmacodynamics of teicoplanin against MRSA[J ] . J Antimicrob Chemother, 2017, 72(12): 3382-3389. DOI:10.1093/jac/dkx289.

刘玉峰, 刘晓刚, 顾晔, 等.左卡尼汀联合抗菌药物治疗自体瓣膜心内膜炎的临床观察[J].中国药房, 2016, 27(14): 1972-1974.

LIU Y F, LIU X G, GU Y, et al . Clinical observation of L-carnitin combined with antibiotics in the treatment of native valve endocarditis[J ] . China Pharm, 2016, 27(14): 1972-1974.

中华医学会心血管病学分会, 中华心血管病杂志编辑委员会.成人感染性心内膜炎预防、诊断和治疗专家共识[J].中华心血管病杂志, 2014, 42(10): 806-816. DOI:10.3760/cma.j.issn.0253-3758.2014.10.004.

Cardiovascular Branch of Chinese Medical Association. Expert consensus on prevention, diagnosis and treatment of adult infective endocarditis[J]. Chin J Cardiol, 2014, 42(10): 806-816. DOI:10.3760/cma.j.issn.0253-3758.2014.10.004.

BREDY C, MINISTERI M, KEMPNY A, et al . New York Heart Association (NYHA) classification in adults with congenital heart disease: relation to objective measures of exercise and outcome[J ] .Eur Heart J Qual Care Clin Outcomes, 2018, 4(1): 51-58. DOI:10.1093/eh jqcco/qcx031.

梁峰. 2015年欧洲心脏病学会关于感染性心内膜炎治疗指南解读[J].中国循证心血管医学杂志, 2017, 15(4): 302-309.

LIANG F. Interpretation of 2015 ESC Guidelines for the management of infective endocarditis[J]. Chin J Cardiovasc Res, 2017, 15 (4): 302-309.

尚红, 王毓三, 申子瑜.全国临床检验操作规程[M].北京:人民卫生出版社, 2015: 26-27.

SHANG H, WANG Y S, SHEN Z Y. National clinical laboratory operating procedures[M]. Beijing: People's Medical Publishing House, 2015: 26-27.

FERNÁNDEZ-HIDALGO N, RIBERA A, LARROSA M N, et al . Impact of Staphylococcusaureus phenotype and genotype on the clinical characteristics and outcome of infective endocarditis. A multicentre, longitudinal, prospective, observational study[J ] . Clin Microbiol Infect, 2018, 24(9): 985-991. DOI: 10.1016/j.cmi.2017.12.002..

VERGARA A, NORMANNO G, DI CICCIO P, et al . Biofilm formation and its relationship with the molecular characteristics of food-related methicillin-resistant Staphylococcusaureus (MRSA)[J ] . J Food Sci, 2017, 82(10): 2364-2370. DOI: 10.1111/1750-3841.13846..

LONGO N, FRIGENI M, PASQUALI M.Carnitine transport and fatty acid oxidation[J]. Biochim Biophys Acta, 2016, 1863(10): 2422-2435. DOI: 10.1016/j.bbamcr.2016.01.023.

MOGHADDAS A, DASHTI-KHAVIDAKI S. L-carnitine and potential protective effects against ischemia-reperfusion injury in noncardiac organs: from experimental data to potential clinical applications[J]. J Diet Suppl, 2018, 15(5): 740-756. DOI: 10.1080/19390211.2017.1359221.

袁保荣, 李敏, 张卉.左卡尼汀联合前列地尔对慢性肾功能衰竭患者合并心功能衰竭的临床疗效[J].药物评价研究, 2017, 40(5): 683-686. DOI: 10.7501/j.issn.1674-6376.2017.05.019.

YUAN B R, LI M, ZHANG H. Clinical efficacy of alprostadil combined with levocarnitine in treatment of chronic renal failure combined with heart failure[J]. Drug Eval Res, 2017, 40(5): 683-686. DOI: 10.7501/j.issn.1674-6376.2017.05.019.

GUO JJ, SHI J R, WANG H Z, et al . Emerging Gram-positive bacteria and drug resistance in cirrhosis patients with spontaneous bacterial peritonitis: a retrospective study[J ] . Exp Ther Med, 2019, 17(6): 4568-4576. DOI: 10.3892/etm.2019.7502.

WANG Z Y, LIU YY, LIU G H, et al . L-carnitine and heart disease[J ] . Life Sci, 2018, 194: 88-97. DOI: 10.1016/j.lfs.2017.12.015.

KANG S E, LEE S J, LEE J Y, et al . Serum levels of IgG antibodies against alpha-enolase are increased in patients with Behçet's disease and are associated with the severity of oral ulcer, erythrocyte sedimentation rates, and C-reactive protein[J ] . Clin Exp Rheumatol, 2017, 35(6): 67-74.

WU F, HOU X Q, SUN R R, et al . The predictive value of joint detection of serum amyloid protein A, PCT, and Hs-CRP in the diagnosis and efficacy of neonatal septicemia[J ] . Eur Rev Med Pharmacol Sci, 2019, 23(13): 5904-5911. DOI: 10.26355/eurrev_201907_18335.

田建华, 张新枝, 王洪, 等.血清PCT和CRP及D-D水平与危重症感染患者IPS评分的关系[J].中华医院感染学杂志, 2018, 28(19): 38-41.

TIAN J H, ZHANG X Z, WANG H, et al . Relationship+between serum PCT, CRP, D-D levels and LPS score in critically ill patients with infections[J ] . Chin J Nosocomiol, 2018, 28(19): 38-41.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Diagnostic values of procalcitonin, platelet, C-reactive protein, erythrocyte sedimentation rate and white blood cell count for Kawasaki disease

Inhibitory effect of emodin on MRSA biofilm and its mechanism

Analysis of influencing factors for serum procalcitonin level in septic patients

Evaluation of a time-resolved fluorescence immunochromatography for procalcitonin

Beta-thujaplicin/ZnO nanoparticles/polycaprolactone/poly(ethylene glycol) nanofibers promotes healing of wounds with methicillin-resistant Staphylococcus aureus infection

Related Author

吴立强

陈建平

何念海

刘婧怡

蔡仑

段浩

刘畅

李海波

Related Institution

Department of Clinical Laboratory, Second Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Pharmacy, Institute of Surgery Research, Third Affiliated Hospital, Army Medical University (Third Military Medical University)

Comprehensive Experimental Center, Faculty of Pharmacy and Laboratory Medicine, Army Medical University (Third Military Medical University)

Biomedical and Health Engineering Laboratory, College of Biological Engineering, Chongqing University

⁰

Clinical efficacy of teicoplanin combined with L-carnitine for methicillin-resistant Staphylococcus aureus infective endocarditis

DOI：10.16016/j.1000-5404.201911097

摘要

Abstract

关键词

Keywords

references