Marget W, Seeliger H P
Institute of Hygiene and Microbiology, University of Würzburg.
Infection. 1988;16 Suppl 2:S175-7. doi: 10.1007/BF01639744.
Listeriosis in humans is a rare disease, which, however, is known to be epidemic and endemic. The prognosis has remained unsatisfactory up to today, the fatality being at least 10% and often considerably higher depending on the clinical features of the disease and the patient's age. Three population groups are at risk: pregnant women, fetuses and newborn infants. Furthermore, immunosuppression in older patients due to disease, therapy, or age also plays a role. The incidence of Listeria infections in patients over 45 is clearly increasing. Due to the nature of the pathogen (in vivo bactericidal concentrations of antibiotics are often not attainable; intracellular growth) a high dosage of ampicillin is recommended. Although the present therapeutic possibilities are not satisfactory, a combination of ampicillin and an aminoglycoside appears to be the best therapy at present. Other combinations such as rifampicin and beta-lactam antibiotics have exhibited in vitro antagonism. The preferred therapy, ampicillin, can only be recommended with reservations because it is not optimally effective.
人类李斯特菌病是一种罕见疾病，但已知具有流行性和地方性。直至今日，其预后仍不尽人意，病死率至少为10%，且常因疾病的临床特征和患者年龄而显著更高。有三类人群面临风险：孕妇、胎儿和新生儿。此外，老年患者因疾病、治疗或年龄导致的免疫抑制也起一定作用。45岁以上患者中李斯特菌感染的发病率明显上升。由于病原体的特性（抗生素在体内常无法达到杀菌浓度；在细胞内生长），建议使用高剂量氨苄西林。尽管目前的治疗方法并不令人满意，但氨苄西林与氨基糖苷类药物联合使用似乎是目前最佳的治疗方案。其他组合如利福平和β-内酰胺类抗生素已显示出体外拮抗作用。首选治疗药物氨苄西林只能谨慎推荐，因为其效果并非最佳。
