Pillai A, Thomas S, Williams C
Dumfries and Galloway Royal Infirmary, Dumfries, DG1 4AP, UK.
J Infect. 2005 Nov;51(4):e207-11. doi: 10.1016/j.jinf.2005.02.013.
We report a case of severe streptococcal cellulitis in a healthy 47 year old male, where the sole microbial isolate was a beta-haemolytic group G Streptococcus. Treatment failure with high dose penicillin was observed despite in vitro sensitivity. The addition of clindamycin resulted in dramatic clinical improvement. This may indicate an Eagle-type effect (whereby antibiotics exhibit paradoxically reduced bactericidal activities at high drug concentrations), in group G beta-haemolytic infections. Although well documented with group A streptococcal infections, this phenomenon has not been fully recognised with group G beta-haemolytic streptococcal infections. This may have important implications for clinical management.
我们报告了一例健康的47岁男性严重链球菌蜂窝织炎病例，其中唯一分离出的微生物是β溶血性G组链球菌。尽管体外药敏试验显示敏感，但高剂量青霉素治疗仍失败。加用克林霉素后临床症状显著改善。这可能表明在G组β溶血性感染中存在伊格尔效应（即抗生素在高药物浓度下杀菌活性反而降低）。虽然A组链球菌感染中对此现象已有充分记录，但G组β溶血性链球菌感染中尚未得到充分认识。这可能对临床管理具有重要意义。
