Felts A G, Grainger D W, Slunt J B
Anthony G. Gristina Institute for Biomedical Research, Herndon, Virginia, USA.
J Trauma. 2000 Nov;49(5):873-8. doi: 10.1097/00005373-200011000-00014.
Nosocomially derived gram-negative infections, particularly from antibiotic-resistant pathogens, are a cause of morbidity in patients with severe burn wounds.
Locally delivered polyclonal antibodies and systemically infused ceftazidime were combined in a lethal murine burn wound model against a virulent Pseudomonas aeruginosa strain that exhibits intermediate resistance to ceftazidime.
Survival was synergistically enhanced in cohorts of burned mice treated both locally (subeschar) with pooled polyclonal human immunoglobulin G (1-mg dose) and intravenously with infused ceftazidime (0.44 mg dose). Enhancement of survival correlated with reduced bacterial quantitation in local and systemic tissue observed in separate burned cohorts. Burned, infected mice treated prophylactically with either individual treatment at the same dose or a combination of both treatments administered systemically showed no survival enhancement as compared with the untreated control group.
Treatment of antibiotic-resistant burn wound infections with antibiotics together with locally delivered immunoglobulins may improve antibiotic protective effects against antibiotic-resistant pathogens.
医院获得性革兰氏阴性菌感染，尤其是来自耐药病原体的感染，是严重烧伤创面患者发病的一个原因。
在致死性小鼠烧伤创面模型中，将局部递送的多克隆抗体与全身输注的头孢他啶联合使用，以对抗对头孢他啶表现出中度耐药的强毒铜绿假单胞菌菌株。
在局部（焦痂下）用混合的多克隆人免疫球蛋白G（1毫克剂量）和静脉内输注头孢他啶（0.44毫克剂量）治疗的烧伤小鼠队列中，生存率得到协同提高。生存率的提高与在单独的烧伤队列中观察到的局部和全身组织中细菌定量减少相关。与未治疗的对照组相比，用相同剂量的单一治疗或全身给予两种治疗的组合进行预防性治疗的烧伤感染小鼠没有显示出生存率提高。
用抗生素和局部递送的免疫球蛋白治疗耐药性烧伤创面感染可能会提高抗生素对耐药病原体的保护作用。
