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[营养缺陷菌属和颗粒链菌属]

[Abiotrophia and Granulicatella].

作者信息

Lopardo Horacio A

机构信息

Servicio de Microbiología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Combate de los Pozos 1881, (1245) Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Rev Argent Microbiol. 2006 Jul-Sep;38(3):164-82.

Abstract

NVS grow in culture media with 0.001% pyridoxal hydrochloride (PHC) and 0.1% cysteine hydrochloride (CysHC). These bacteria need the help of other organisms to grow on common solid media showing the effect known as "satellitism". Both, satellitism and the pyrrolidonilarilamidase test are the key tests for suspecting the presence of NVS. They can grow as a faint haze on blood agar or chocolate agar prepared with the Columbia agar base without adding any other substance. The most frequently documented infections are endocarditis. Among extravascular infections, ocular infections predominate. For antimicrobial susceptibility testing, the Etest and dilution methods with the addition of 0.001% PHC can be used. Whichever the method there does not seem to be much correlation in vitro/ in vivo. The rate of penicillin resistance and the MICs were similar to those observed in viridans group streptococci. Four to six weeks of penicillin plus gentamicin is recommended for the treatment of VNS endocarditis. In cases of treatment failure or beta-lactam allergic susceptibility, vancomycin alone or with the addition of gentamicin and/or rifampin is used.

摘要

NVS在含有0.001%盐酸吡哆醛(PHC)和0.1%盐酸半胱氨酸(CysHC)的培养基中生长。这些细菌需要其他生物体的帮助才能在普通固体培养基上生长,表现出被称为“卫星现象”的效应。卫星现象和吡咯烷酮芳基酰胺酶试验都是怀疑存在NVS的关键试验。它们可以在以哥伦比亚琼脂为基础制备的血琼脂或巧克力琼脂上以微弱的薄雾状生长,无需添加任何其他物质。最常记录的感染是心内膜炎。在血管外感染中,眼部感染占主导。对于抗菌药物敏感性试验,可以使用添加0.001% PHC的Etest和稀释法。无论采用哪种方法,体外/体内似乎都没有太多相关性。青霉素耐药率和最低抑菌浓度与草绿色链球菌中观察到的相似。推荐使用青霉素加庆大霉素治疗VNS心内膜炎4至6周。在治疗失败或对β-内酰胺类药物过敏的情况下,单独使用万古霉素或加用庆大霉素和/或利福平。

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