Santoianni J E, Abalo A B, Figueroa A S, Predari S C
Medicina (B Aires). 1989;49(4):357-9.
A 50 year old woman while undergoing severe treatment for rheumatoid arthritis, developed anaerobic meningitis. The cerebrospinal fluid (CSF) sample was transported and cultivated aerobically and anaerobically. After 48 h at 37 degrees C the anaerobically incubated plate, the enriched fluid thioglycollate medium and the anaerobic culture medium yielded luxuriant growth of an anaerobic Gram negative bacillum. The biochemical and antimicrobial susceptibility patterns were consistent with those for Bacteroides distasonis. Most of the strains of the 5 species included in the Bacteroides fragilis group (B. fragilis, B. vulgatus, B. ovatus, B. thetaiotaomicron and B. distasonis) are resistant to penicillins, cephalosporins of first generation and aminoglycosides. Anaerobic polyresistant flora from an intraabdominal focus (chronic cholecystitis) might have been selected by treatment with gentamicin and cephalotin, and proliferated into meningeal dissemination. It is important that CSF from immunocompromised patients with acute or chronic pulmonary, intraabdominal or cranium-facial infectious processes be transported and cultured in aerobic and anaerobic conditions. These patients must be treated with an initial therapeutic scheme that includes an effective antibiotic for the anaerobic microorganism that may be involved.
一名50岁女性在接受类风湿关节炎的强化治疗时，发生了厌氧性脑膜炎。采集了脑脊液（CSF）样本，并分别进行需氧和厌氧培养。在37℃下厌氧培养48小时后，厌氧培养平板、改良硫乙醇酸盐流体培养基和厌氧培养基中均长出了大量的厌氧革兰阴性杆菌。其生化和药敏模式与狄氏拟杆菌一致。脆弱拟杆菌群（脆弱拟杆菌、普通拟杆菌、卵形拟杆菌、多形拟杆菌和狄氏拟杆菌）中的5个菌种的大多数菌株对青霉素、第一代头孢菌素和氨基糖苷类耐药。腹腔内病灶（慢性胆囊炎）的厌氧多重耐药菌群可能因庆大霉素和头孢噻吩治疗而被选择，并扩散至脑膜。对于患有急性或慢性肺部、腹腔内或颅面部感染性疾病的免疫受损患者，其脑脊液必须在需氧和厌氧条件下运送和培养，这一点很重要。这些患者必须采用初始治疗方案，其中包括针对可能涉及的厌氧微生物的有效抗生素。
