Jacobs R F, Wilson C B
Pediatr Res. 1983 Nov;17(11):916-9. doi: 10.1203/00006450-198311000-00016.
Patients with chronic granulomatous disease (CGD) have recurrent infections with catalase-producing organisms, particularly staphylococci, that survive within their leukocytes. To be most effective, antibiotics used to treat infections in CGD patients may need to kill both intracellular and extracellular organisms. We studied the ability of certain antibiotics to penetrate normal and CGD neutrophils and to kill intracellular staphylococci. Trimethoprim and clindamycin were concentrated in normal and in CGD neutrophils; maximum cellular-to-extracellular concentration ratios of clindamycin and of trimethoprim were approximately 30 and approximately 4, respectively. In contrast, penicillin was excluded from normal neutrophils. Clindamycin, trimethoprim/sulfamethoxazole, rifampin, and trimethoprim/rifampin significantly reduced the number of viable intracellular staphylococci in normal and CGD neutrophils. After 24 h of incubation in the presence of these antibiotics, the number of viable intracellular staphylococci in normal and CGD neutrophils was similar. In contrast, dicloxacillin, gentamicin, and cephalothin had no significant effect on the number of intracellular staphylococci in normal or CGD neutrophils.
慢性肉芽肿病（CGD）患者会反复感染产过氧化氢酶的微生物，尤其是葡萄球菌，这些微生物可在其白细胞内存活。为达到最佳疗效，用于治疗CGD患者感染的抗生素可能需要杀灭细胞内和细胞外的微生物。我们研究了某些抗生素穿透正常和CGD中性粒细胞以及杀灭细胞内葡萄球菌的能力。甲氧苄啶和克林霉素可在正常和CGD中性粒细胞中蓄积；克林霉素和甲氧苄啶的最大细胞内与细胞外浓度比分别约为30和约4。相比之下，青霉素无法进入正常中性粒细胞。克林霉素、甲氧苄啶/磺胺甲恶唑、利福平以及甲氧苄啶/利福平可显著减少正常和CGD中性粒细胞内活葡萄球菌的数量。在这些抗生素存在的情况下孵育24小时后，正常和CGD中性粒细胞内活葡萄球菌的数量相似。相比之下，双氯西林、庆大霉素和头孢噻吩对正常或CGD中性粒细胞内葡萄球菌的数量没有显著影响。
