Gutschik E
Acta Pathol Microbiol Immunol Scand B. 1982 Aug;90(4):295-302.
The purpose of this study was to investigate the efficacy of long-term penicillin-gentamicin treatment on experimental S. faecalis endocarditis due to selected strains; one strain was homogeneously resistant to 8000 micrograms/ml streptomycin (IC50 and MIC greater than 8000 micrograms ml), the other strain heterogeneously resistant to 8000 micrograms/ml streptomycin (IC50: 3300 micrograms/ml, MIC: greater than 8000 micrograms/ml. Both strains showed low-grade resistance to gentamicin (MIC 10.5 and 25 micrograms/ml, respectively). The results showed that there was significant effect of the treatment in rabbits with endocarditis due to both strains, as measured by lowered mortality and by high bacteriologic cure rate. Despite effective antibiotic treatment, a high incidence (57%) of congestive heart failure was noted in rabbits late in the treatment period or after termination of antibiotic treatment, probably due to healing processes on the aortic valves. In human cases of S. faecalis endocarditis the antibiotic treatment should be either penicillin plus streptomycin or penicillin plus gentamicin. However, in cases where the infecting strain is homogeneously resistant to 8000 micrograms/ml streptomycin, the treatment with penicillin plus gentamicin is clearly the drug combination of choice.
本研究的目的是调查长期使用青霉素 - 庆大霉素治疗由特定菌株引起的实验性粪肠球菌心内膜炎的疗效；一株对8000微克/毫升链霉素呈均一性耐药（IC50和MIC大于8000微克/毫升），另一株对8000微克/毫升链霉素呈异质性耐药（IC50：3300微克/毫升，MIC：大于8000微克/毫升）。两株菌对庆大霉素均表现出低度耐药（MIC分别为10.5和25微克/毫升）。结果显示，通过降低死亡率和高细菌治愈率来衡量，该治疗方法对由这两种菌株引起的心内膜炎的兔子有显著效果。尽管进行了有效的抗生素治疗，但在治疗后期或抗生素治疗终止后，兔子中仍有高发生率（57%）的充血性心力衰竭，这可能是由于主动脉瓣的愈合过程所致。在人类粪肠球菌心内膜炎病例中，抗生素治疗应为青霉素加链霉素或青霉素加庆大霉素。然而，在感染菌株对8000微克/毫升链霉素呈均一性耐药的情况下，青霉素加庆大霉素的治疗显然是首选的药物组合。
