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[厌氧非梭菌感染所致伤口的经验性抗生素治疗]

[Empirical antibiotic therapy of wounds complicated by anaerobic non-clostridial infection].

作者信息

Borisova O K, Pavlova M V, Iakovlev V P, Kuleshov S E

出版信息

Antibiot Khimioter. 1989 Sep;34(9):707-11.

PMID:2575366
Abstract

Antibacterial activity of 14 drugs against clinical strains of asporogenic anaerobes causing wound infections in the soft tissues i. e. Bacteroides fragilis and Bacteroides melaninogenicus as well as anaerobic gram-positive++ cocci was assayed with the method of serial dilutions in agar. It was shown that among the investigated species B. fragilis had the most marked resistance since out of the 14 drugs only 8 were sufficiently active against it i.e. carbenicillin, levomycetin, lincomycin, dioxidine, metronidazole, thinidazole, nitrazole and erythromycin. The choice of drugs for treating infections caused by B. melaninogenicus and anaerobic grampositive cocci unlike those caused by B. fragilis offered no difficulty since practically++ all the investigated drugs were highly active against the causative agents. There was observed relationship between the frequency of asporogenic anaerobes and the wound genesis. The characteristic features of the species composition connected with localization of the suppurative foci were indicated. The detected specific antimicrobial profiles of the asporogenic anaerobes causing wound infections and the peculiarity of their participation in development of purulent infections of the soft tissues provided a differential approach to empirical antibacterial therapy prior to the pathogen bacteriological investigation and availability of the antibioticograms.

摘要

采用琼脂连续稀释法测定了14种药物对引起软组织伤口感染的不产芽孢厌氧菌临床菌株(即脆弱拟杆菌和产黑素拟杆菌)以及厌氧革兰氏阳性球菌的抗菌活性。结果表明,在所研究的菌种中,脆弱拟杆菌的耐药性最为明显,因为在这14种药物中,只有8种对其有足够的活性,即羧苄青霉素、氯霉素、林可霉素、二氧嗪、甲硝唑、替硝唑、硝唑尼特和红霉素。与脆弱拟杆菌引起的感染不同,选择治疗产黑素拟杆菌和厌氧革兰氏阳性球菌引起的感染的药物没有困难,因为实际上所有研究的药物对病原体都有高度活性。观察到不产芽孢厌氧菌的频率与伤口发生之间的关系。指出了与化脓性病灶定位相关的菌种组成特征。所检测到的引起伤口感染的不产芽孢厌氧菌的特定抗菌谱及其参与软组织化脓性感染发展的特点,为在病原菌细菌学调查和药敏试验结果可用之前进行经验性抗菌治疗提供了一种鉴别方法。

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