LACTOBACILLEMIA - REPORT OF 9 CASES - IMPORTANT CLINICAL AND THERAPEUTIC CONSIDERATIONS
LACTOBACILLEMIA - REPORT OF 9 CASES - IMPORTANT CLINICAL AND THERAPEUTIC CONSIDERATIONS
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DOI：
10.1016/0002-9343(78)90521-1
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发表时间：
1978-01-01
影响因子：
5.9
通讯作者：
GUZE, LB
中科院分区：
文献类型：
--
作者：
BAYER, AS;CHOW, AW;GUZE, LB
由于乳酸杆菌引起的严重感染很少被引用。本文报告了9例乳杆菌血症患者的临床表现。在结合文献和当前经验中，局部化脓引起的心内膜炎和脓毒症是最常见的临床综合征，最常见于既往口咽部感染。乳杆菌性心内膜炎表现为左侧心脏受累（100%）和全身动脉栓塞（55%）。检测了9株临床分离株对5种具有宽革兰氏阳性谱的药物的最小抑菌浓度和杀菌浓度（MIC和MBC）;这些微生物表现出无法实现MBC的高发生率（64%）和差异很大（> 100倍）的MIC：MBC比（38%）。这与乳酸杆菌心内膜炎中的观察结果雅阁，尽管有适当的治疗方案和可达到的微生物MIC，但体内临床反应较差。对2个心内膜炎分离株的杀菌协同研究表明，当单一抗菌药物无法治愈时，青霉素类加氨基糖苷类可能对治疗深层乳酸杆菌感染有用。
Serious infections due to lactobacilli have been rarely cited. Findings in 9 recent patients with lactobacillemia are reported. In the combined literature and current experience, endocarditis and sepsis from localized suppuration were the most common clinical syndromes, most frequently arising from prior oropharyngeal infections. Lactobacillus endocarditis showed a predilection for left-sided cardiac involvement (100%) and systemic arterial embolization (55%). The 9 clinical isolates were tested for minimal inhibitory and bactericidal concentrations (MICs and MBCs) against 5 drugs with broad gram-positive spectrums; these organisms demonstrated a high incidence of unachievable MBCs (64%) and widely disparate (> 100 fold) MIC:MBC ratios (38%). This is in accord with observations in Lactobacillus endocarditis of poor in vivo clinical response despite appropriate regimens and achievable MICs of the organisms. Bactericidal synergistic studies on 2 endocarditis isolates indicated that the penicillins plus aminoglycosides may be potentially useful in the treatment of deep-seated Lactobacillus infections when single antimicrobials fail to achieve a cure.