Craven P C, Jorgensen J H, Kaspar R L, Drutz D J
Am J Med. 1977 Jun;62(6):902-10. doi: 10.1016/0002-9343(77)90659-3.
Over a recent 22 month period, 222 patients in two adjacent hospitals became infected with a multiply antibiotic-resistant strain of Serratia marcescens; 13 were bacteremic. Nineteen patients with clinically significant infections received amikacin. Nine of 11 patients with urinary tract infections were cured. In contrast, only one of eight patients with pneumonia or other deep tissue infections was cured and four died. These eight patients were severely ill; many had infections with multiple microorganisms. In four of five patients in whom the infection failed to clear promptly. Serratia strains became increasingly resistant to amikacin during therapy and these strains contributed to the death of two of these patients. Amikacin proved useful in treating patients with infections due to gentamicin-resistant S. marcescens organisms, especially urinary tract infections. However, the capacity of some strains of S. marcescens to develop resistance to amikacin may limit the usefulness of this antibiotic in the treatment of deep tissue infections which involve this microorganism.
在最近22个月的时间里，相邻两家医院的222名患者感染了多重耐药性粘质沙雷氏菌；其中13人发生菌血症。19例有临床意义感染的患者接受了阿米卡星治疗。11例尿路感染患者中有9例治愈。相比之下，8例肺炎或其他深部组织感染患者中仅1例治愈，4例死亡。这8例患者病情严重；许多人感染了多种微生物。在5例感染未能迅速清除的患者中，有4例在治疗期间粘质沙雷氏菌菌株对阿米卡星的耐药性不断增强，其中2例患者的死亡与此类菌株有关。事实证明，阿米卡星对治疗由耐庆大霉素的粘质沙雷氏菌引起感染的患者有效，尤其是尿路感染。然而，某些粘质沙雷氏菌菌株对阿米卡星产生耐药性的能力，可能会限制这种抗生素在治疗涉及该微生物的深部组织感染中的作用。
