Stollerman G H
Ann Intern Med. 1978 Nov;89(5 Pt 2 Suppl):746-8. doi: 10.7326/0003-4819-89-5-746.
Antibiotic usage and improved living conditions may have contributed to a dilution of "rheumatogenic" strains of group A streptococci and to their replacement by attenuated streptococci with less rheumatogenic potential. Whether this is due to decreased virulence or to loss of specific bacterial antigens or toxins in prevalent strains is not yet known. The pneumococcus, which has been moderately resistant to antibiotics only in isolated cases, has appeared in South Africa in strains that are highly resistant to at least five major antibiotics; plasmid transmission of resistance is suspected. The newly available pneumococcal vaccine may become very important if such strains spread. Gonococci isolated from urogenital lesions have developed only moderate drug resistance. Gonococci causing disseminated infection have retained their exquisite sensitivity to penicillin; the most virulent strains are associated with greatest sensitivity. However, the newly discovered penicillinase-plasmid in gonococci is transferable to these virulent strains as readily as to others.
抗生素的使用以及生活条件的改善可能导致了A组链球菌“致风湿性”菌株的稀释，并使其被具有较低致风湿潜力的减毒链球菌所取代。这是由于流行菌株的毒力降低，还是特定细菌抗原或毒素的丧失，目前尚不清楚。肺炎球菌仅在个别情况下对抗生素有中度耐药性，而在南非出现的菌株对至少五种主要抗生素具有高度耐药性；怀疑存在耐药性的质粒传播。如果此类菌株传播，新上市的肺炎球菌疫苗可能会变得非常重要。从泌尿生殖系统病变中分离出的淋球菌仅产生了中度耐药性。引起播散性感染的淋球菌对青霉素仍保持着极高的敏感性；毒性最强的菌株与最高的敏感性相关。然而，新发现的淋球菌青霉素酶质粒可同样容易地转移到这些毒性菌株以及其他菌株中。
