ASSOCIATION OF PENICILLIN TOLERANCE WITH FAILURE TO ERADICATE GROUP-A STREPTOCOCCI FROM PATIENTS WITH PHARYNGITIS
ASSOCIATION OF PENICILLIN TOLERANCE WITH FAILURE TO ERADICATE GROUP-A STREPTOCOCCI FROM PATIENTS WITH PHARYNGITIS
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DOI：
10.1016/s0022-3476(85)80392-9
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发表时间：
1985-01-01
影响因子：
5.1
通讯作者：
KAPLAN, EL
中科院分区：
文献类型：
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作者：
KIM, KS;KAPLAN, EL
尽管 A 组链球菌对青霉素具有一致的敏感性，但在接受青霉素治疗咽炎的患者中未能根除 A 组链球菌的情况并不少见。我们探讨了青霉素耐受性可以解释这种现象的可能性。我们检测了来自 48 名青霉素治疗成功患者（链球菌已根除）的 48 株 A 组链球菌分离株，以及来自 37 名对青霉素治疗无效（链球菌未根除）的患者（每名患者 1 至 4 株）的 92 株分离株。青霉素耐受性通过梯度重复平板法和青霉素浓度为最小抑制浓度16倍的时间灭活实验来识别。治疗失败组中 25% 的菌株（92 株中的 23 株）发现了耐受性，而治疗成功组中则没有菌株出现耐受性。通过 M 和 T 分型对菌株进行的表征表明，耐受菌株中没有占优势的类型。这些发现表明，青霉素耐受性可能是青霉素无法根除链球菌扁桃体炎或咽炎患者上呼吸道中的 A 族链球菌的某些情况的原因。
Despite uniform susceptibility of group A streptococci to penicillin, failure to eradicate group A streptococci is not uncommon in patients receiving penicillin for treatment of pharyngitis. We explored the possibility that penicillin tolerance could explain this phenomenon. We examined 48 group A streptococcal isolates from 48 patients successfully treated with penicillin (streptococci eradicated) and 92 isolates from 37 patients (one to four isolates per patient) who failed to respond to penicillin therapy (streptococci not eradicated). Penicillin tolerance was recognized by the gradient-replicate plate method and by time-kill experiments with penicillin concentrations of 16 times the minimal inhibiting concentrations. Tolerance was identified in 25% (23 of 92) of the isolates from the treatment failure group, in contrast to none of the strains from the treatment success group. Characterization of the strains by M and T typing revealed no predominant type(s) among the tolerant strains. These findings suggest that penicillin tolerance may be responsible for some instances of failure of penicillin to eradicate group A streptococci from the upper respiratory tract of individuals with streptococcal tonsillitis or pharyngitis.