Johnson R C
Department of Microbiology, University of Minnesota Medical School, Minneapolis.
Rev Infect Dis. 1989 Sep-Oct;11 Suppl 6:S1505-10. doi: 10.1093/clinids/11.supplement_6.s1505.
Leptospira interrogans can be cultured from blood and cerebrospinal fluid during the first week of leptospirosis and from urine thereafter. Studies of in vitro sensitivity indicate that these organisms are sensitive to most antibiotics. Tetracycline and penicillin G are most often used clinically, although laboratory studies suggest that the bactericidal activity of penicillin G may be inadequate. Treponema pallidum cannot be satisfactorily cultured. It is identified by dark-field microscopy. Studies of in vivo sensitivity show that penicillin G is highly active against the syphilis pathogen. Since syphilis and gonorrhea may occur simultaneously, ceftriaxone, which is as active as penicillin G against T. pallidum but is also active against penicillinase-producing gonococci, is a logical choice for therapy. Borrelia burgdorferi has been cultured from the blood, cerebrospinal fluid, and skin of patients with Lyme disease. In vitro studies have shown tetracycline and erythromycin to be effective against B. burgdorferi and penicillin G to be less so, although all are commonly used clinically. Ceftriaxone has also proven to be highly effective in laboratory studies and for clinical treatment.
问号钩端螺旋体在钩端螺旋体病的第一周可从血液和脑脊液中培养出来，此后可从尿液中培养。体外敏感性研究表明，这些微生物对大多数抗生素敏感。四环素和青霉素G是临床上最常用的药物，尽管实验室研究表明青霉素G的杀菌活性可能不足。梅毒螺旋体不能令人满意地培养。它通过暗视野显微镜鉴定。体内敏感性研究表明，青霉素G对梅毒病原体具有高度活性。由于梅毒和淋病可能同时发生，头孢曲松对梅毒螺旋体的活性与青霉素G相同，但对产青霉素酶的淋球菌也有活性，是一种合理的治疗选择。伯氏疏螺旋体已从莱姆病患者的血液、脑脊液和皮肤中培养出来。体外研究表明，四环素和红霉素对伯氏疏螺旋体有效，而青霉素G的效果较差，尽管所有这些药物在临床上都常用。头孢曲松在实验室研究和临床治疗中也已证明非常有效。
