Bussiére J L, Lopitaux R, Sirot J, Cluzel R, Rampon S
Rev Rhum Mal Osteoartic. 1978 Apr;45(4):259-68.
Study of 26 cases of osteo-articular infections with an identified organism collected in a rheumatology department, has confirmed in the first place the increasing importance of gram negative organisms, compared with the staphylococcus which has always mainly predominated in this type of infection. In each case, the authors have made as complete a bacteriological study as possible, including antibiotic sensitivities, the measurement of the minimum inhibitory concentration of the antibiotics on the isolated strains, study of the bactericidal power in vitro of various combinations, and study of the inhibitory power of the serum on the organism. This study of the inhibitory power of the serum approximates most closely to testing the antibiotic activities in vivo, since one cannot make this assessment, in most cases, within the infective focus itself. Rifampicin, with the imperative condition that it is not used alone, is a major antibiotic in the osteo-articular infections, by reason of its very great activity against the staphylococcus, its excelent penetration into bone, and its ease of use. Other recognized anti-staphylococcal antibiotics behave in a more disappointing fashion. When the effectiveness of treatment is checked regularly by the inhibitory power of the serum, together with the other classical criteria of surveillance, cure of the infection as been achieved in every case.
对某风湿病科收集的26例已鉴定出病原体的骨关节炎感染病例的研究，首先证实了革兰氏阴性菌的重要性日益增加，相比之下，葡萄球菌在这类感染中一直占据主要地位。在每个病例中，作者都尽可能进行了全面的细菌学研究，包括抗生素敏感性、抗生素对分离菌株的最低抑菌浓度测定、各种组合的体外杀菌力研究以及血清对病原体的抑制力研究。血清抑制力的这项研究最接近体内抗生素活性测试，因为在大多数情况下，无法在感染灶本身进行这种评估。利福平在骨关节炎感染中是一种主要抗生素，前提是不单独使用，这是由于它对葡萄球菌具有很强的活性、能很好地渗透到骨骼中且使用方便。其他公认的抗葡萄球菌抗生素表现则较为令人失望。当通过血清抑制力以及其他常规监测标准定期检查治疗效果时，每个病例的感染均已治愈。
