Palmer D W
Arthritis Rheum. 1975 Jul-Aug;18(4):339-45. doi: 10.1002/art.1780180408.
The knee of a boy with sickle-cell thalassemia became infected with Salmonella enteritidis, sensitive to ampicillin. Doses of ampicillin that achieved anti-bacterial titers of 32 in synovial fluid failed to eradicate the organism. The synovial fluid exhibited severe hypoxia, hypercapnia, and lactic acidosis. Methods were developed to estimate the oxygen saturation of blood in regional venous capillaries, the degree of periarticular sickling, changes in the viscosity of local blood, and the articular ratio of blood flow to oxygen utilization. The results suggest that local vascular insufficiency associated with sickling may affect host response to infection and efficacy of antibiotics. The Salmonella C1 readily transformed to an L form on hypertonic medium, thus acquiring resistance to ampicillin and other cell-wall inhibitors.
一名患有镰状细胞性地中海贫血的男孩膝盖感染了对氨苄青霉素敏感的肠炎沙门氏菌。在滑液中达到抗菌效价为32的氨苄青霉素剂量未能根除该病原体。滑液表现出严重的低氧血症、高碳酸血症和乳酸性酸中毒。已开发出方法来估计局部静脉毛细血管中的血氧饱和度、关节周围镰状化程度、局部血液粘度变化以及血流与氧利用的关节比率。结果表明，与镰状化相关的局部血管功能不全可能会影响宿主对感染的反应以及抗生素的疗效。肠炎沙门氏菌C1在高渗培养基上很容易转变为L型，从而获得对氨苄青霉素和其他细胞壁抑制剂的耐药性。
