目的 调查感染性心内膜炎瓣膜赘生物分离培养的病原菌分布以及耐药性，为本地区感染性心内膜的诊治提供依据。方法 选择2016年3月至2022年12月我院收治的185名感染性心内膜炎并接受心脏手术的患者，收集临床数据。从瓣膜赘生物的培养中分离出病原菌，并对常见致病菌进行药敏试验。结果 瓣膜赘生物培养的阳性率为53.5％（99/185），瓣膜赘生物培养中分离的病原菌包括链球菌属70株（70.7％，70/99）、葡萄球菌属17株（17.2％，17/99）、营养变异链球菌5株（5.0％，5/99）、肠球菌属2株（2.0％，2/99）、HACEK菌群2株（2.0％，2/99）、布鲁氏菌1株（1.0％，1/99）、溶血孪生球菌1株（1.0％，1/99）和假单胞菌1株（1.0％，1/99）。链球菌属对青霉素、头孢噻肟、头孢吡肟、万古霉素、美罗培南、达托霉素和利奈唑胺完全敏感，而对四环素（47.1％，33/70）、红霉素（38.6％，27/70）、克林霉素（27.1％，19/70）、左氧氟沙星（7.1％，5/70）和氯霉素（1.4％，1/70）部分耐药。葡萄球菌属对万古霉素、替考拉宁、达托霉素、米诺环素、氯霉素和利奈唑胺完全敏感，对青霉素、甲氧西林、红霉素和克林霉素的耐药率分别为100％、76.5％、41.2％和35.3％，对其他常用药物的耐药率为10%至20%。结论 感染性心内膜炎病原菌仍然以链球菌属和葡萄球菌属为主；瓣膜赘生物培养阳性在补充和确证血培养方面具有价值；青霉素仍然是治疗链球菌性IE的推荐药物，万古霉素可作为链球菌属和葡萄球菌属重症感染的可行选择。

Objective To investigate the distribution and drug resistance of pathogenic bacteria isolated and cultured from valve vegetations in infective endocarditis, and to provide evidence for diagnosis and treatment of infective endocarditis in this area. Methods A total of 185 patients with infective endocarditis and cardiac surgery admitted to our hospital from March 2016 to December 2022 were selected to collect clinical data. Pathogens were isolated from the culture of valvular vegetations, and drug susceptibility tests were performed on common pathogens. Results The positive rate of valvular vegetation culture was 53.5% (99/185), and the pathogenic bacteria isolated from valvular vegetation culture included 70 strains of Streptococcus spp. (70.7%, 70/99) and 17 strains of Staphylococcus spp. (17.2%, 17/99), 5 strains of nutritionally variant Streptococci (5.0%, 5/99), 2 strains of Enterococcus spp. (2.0%, 2/99), 2 strains of HACEK organisms (2.0%, 2/99), 1 strain of Brucella ovis (1.0%, 1/99), 1 strain of Gemella haemolysans (1.0%, 1/99) and 1 strain of Pseudomonas (1.0%, 1/99). Streptococci spp. was completely sensitive to penicillin, cefotaxime, cefepime, vancomycin, meropenem, daptomycin and linezolid, while was partially resistant to tetracycline (47.1%, 33/70), erythromycin (38.6% , 27/70), clindamycin (27.1%, 19/70), levofloxacin (7.1%, 5/70) and chloramphenicol (1.4%, 1/70). Staphylococci spp. was completely sensitive to vancomycin, teicolanin, dattomycin, minocycline, chloramphenicol and linezolid, with resistance rates of 100%, 76.5%, 41.2% and 35.3% to penicillin, methicillin, erythromycin and clindamycin, respectively, and 10% to 20% to other commonly used drugs. Conclusions The main pathogens of infective endocarditis were Streptococcus spp. and Staphylococcus. spp. Positive valvular vegetation culture is valuable in supplementing and confirming blood culture. Penicillin remains the recommended treatment for streptococcal IE, and vancomycin can be a viable option for severe infections of Streptococcus spp. and Staphylococcus spp.