Zimmerli W, Lew P D, Suter S, Wyss M, Waldvogel F A
Helv Paediatr Acta. 1983 Mar;38(1):51-61.
We report the case of a one-year-old boy with chronic granulomatous disease (CGD), characterized by a defect in the polymorphonuclear leukocytes (PMN) which ingest, but do not kill catalase-positive bacteria such as S. aureus. This well-known observation led us to study the ability of clindamycin, rifampin, co-trimoxazole (TMP-SMX), methicillin and gentamicin to kill intracellular S. aureus in CGD and in normal PMN. Clindamycin killed S. aureus more effectively when these bacteria were intracellular than in the absence of PMN; rifampin was equally active on the same microorganisms in presence and absence of PMN, whereas TMP-SMX, methicillin and gentamicin were less effective in killing intracellular S. aureus. Similar results were obtained in CGD and in normal PMN. These results suggest that clindamycin and rifampin would be a reasonable choice in the treatment of staphylococcal infections in patients with CGD.
我们报告了一名患有慢性肉芽肿病（CGD）的一岁男孩的病例，该病的特征是多形核白细胞（PMN）存在缺陷，这些细胞能够吞噬但无法杀死过氧化氢酶阳性细菌，如金黄色葡萄球菌。这一广为人知的观察结果促使我们研究克林霉素、利福平、复方新诺明（TMP-SMX）、甲氧西林和庆大霉素在CGD患者及正常PMN中杀死细胞内金黄色葡萄球菌的能力。当这些细菌存在于细胞内时，克林霉素杀死金黄色葡萄球菌的效果比不存在PMN时更有效；利福平在有或没有PMN的情况下对相同微生物的活性相同，而TMP-SMX、甲氧西林和庆大霉素在杀死细胞内金黄色葡萄球菌方面效果较差。在CGD患者和正常PMN中获得了类似结果。这些结果表明，克林霉素和利福平可能是治疗CGD患者葡萄球菌感染的合理选择。
