Bentzel David E, Elliott Thomas B, Keller Christopher E, Brook Itzhak, Shoemaker Michael O, Knudson Gregory B
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814, USA.
Comp Med. 2004 Apr;54(2):185-92.
Klebsiella pneumoniae is a common cause of nosocomially acquired pneumonia in immunocompromised patients. Previously, we established a pneumonia model using Klebsiella pneumoniae in B6D2F1/J mice sublethally irradiated with 7-Gy 60Co gamma-radiation and inoculated intratracheally. In the study reported here, we investigated survival of mice following 10 days of antimicrobial therapy with ceftriaxone, gentamicin, gatifloxacin, and a ceftriaxone-gentamicin combination given once daily. Survival was significantly prolonged in response to all therapies. However, survival of mice was 95% when treated with the ceftriaxone-gentamicin combination followed by ceftriaxone alone (75%), and gatifloxacin (80%), whereas survival for controls was 0%. In addition, resistance to any of the treatments did not develop during the study. We conclude that an immunocompromised status does not alter the Infectious Disease Society of America's primary recommendation for treating community-acquired K. pneumoniae pneumonia using a third-generation cephalosporin, with or without an aminoglycoside.
肺炎克雷伯菌是免疫功能低下患者医院获得性肺炎的常见病因。此前，我们利用肺炎克雷伯菌在经7戈瑞60钴γ射线亚致死剂量照射并经气管内接种的B6D2F1/J小鼠中建立了肺炎模型。在本文报道的研究中，我们调查了每日一次给予头孢曲松、庆大霉素、加替沙星以及头孢曲松 - 庆大霉素联合用药进行10天抗菌治疗后小鼠的存活率。所有治疗均使存活率显著延长。然而，先采用头孢曲松 - 庆大霉素联合治疗，随后单独使用头孢曲松（75%）以及使用加替沙星（80%）治疗的小鼠存活率为95%，而对照组的存活率为0%。此外，在研究期间未出现对任何一种治疗的耐药性。我们得出结论，免疫功能低下状态不会改变美国传染病学会关于使用第三代头孢菌素（无论是否联合氨基糖苷类药物）治疗社区获得性肺炎克雷伯菌肺炎的主要推荐。
