Alford R H
Medical Service, Veterans Administration Hospital, Nashville, Tennessee 37203.
Rev Infect Dis. 1979 Jan-Feb;1(1):175-82. doi: 10.1093/clinids/1.1.175.
A nosocomial outbreak of infections due to bacteria resistant to multiple antibiotics evolved into an endemic prevalence of several antibiotic-resistant gram-negative rods. The resistance of these bacteria to available beta-lactam antibiotics, a variety of broad-spectrum agents, and available aminoglycosides other than amikacin led to an evaluation of cefoxitin, a beta-lactamase-resistant cephamycin. Most multiply resistant isolates of Klebsiella pneumoniae, Serratia marcescens, and Proteus mirabilis were sensitive to cefoxitin in vitro. Cefoxitin therapy of 11 severe nosocomial infections caused by multiply resistant K. pneumoniae resulted in clinical and bacteriologic cure in seven patients.
由对多种抗生素耐药的细菌引起的医院感染暴发演变成了几种耐抗生素革兰氏阴性杆菌的地方性流行。这些细菌对现有的β-内酰胺类抗生素、多种广谱药物以及除阿米卡星之外的现有氨基糖苷类抗生素具有耐药性，这促使人们对一种耐β-内酰胺酶的头孢霉素——头孢西丁进行评估。大多数多重耐药的肺炎克雷伯菌、粘质沙雷氏菌和奇异变形杆菌分离株在体外对头孢西丁敏感。对11例由多重耐药肺炎克雷伯菌引起的严重医院感染进行头孢西丁治疗，结果7例患者实现了临床和细菌学治愈。
