Infectious Diseases Service, University of Lausanne, Lausanne, Switzerland.
FEMS Microbiol Rev. 2010 May;34(3):260-80. doi: 10.1111/j.1574-6976.2009.00207.x. Epub 2009 Dec 17.
Despite using modern microbiological diagnostic approaches, the aetiological agents of pneumonia remain unidentified in about 50% of cases. Some bacteria that grow poorly or not at all in axenic media used in routine clinical bacteriology laboratory but which can develop inside amoebae may be the agents of these lower respiratory tract infections (RTIs) of unexplained aetiology. Such amoebae-resisting bacteria, which coevolved with amoebae to resist their microbicidal machinery, may have developed virulence traits that help them survive within human macrophages, i.e. the first line of innate immune defence in the lung. We review here the current evidence for the emerging pathogenic role of various amoebae-resisting microorganisms as agents of RTIs in humans. Specifically, we discuss the emerging pathogenic roles of Legionella-like amoebal pathogens, novel Chlamydiae (Parachlamydia acanthamoebae, Simkania negevensis), waterborne mycobacteria and Bradyrhizobiaceae (Bosea and Afipia spp.).
尽管采用了现代微生物学诊断方法，但仍有约 50%的肺炎病例无法确定病因。一些在常规临床细菌学实验室中使用的、在无菌培养基中生长不良或根本不生长的细菌，但在变形虫内却能生长，可能是这些病因不明的下呼吸道感染（RTIs）的病原体。这些与变形虫共同进化以抵抗其杀菌机制的抗变形虫细菌可能已经发展出有助于它们在人类巨噬细胞内生存的毒力特征，即肺部先天免疫防御的第一道防线。在这里，我们回顾了各种抗变形虫微生物作为人类 RTIs 病原体的新兴致病作用的现有证据。具体而言，我们讨论了军团菌样变形虫病原体、新型衣原体（Parachlamydia acanthamoebae、Simkania negevensis）、水传播分枝杆菌和 Bradyrhizobiaceae（Bosea 和 Afipia spp.）的新兴致病作用。
