Mascellino M T, Iona E, Ponzo R, Mastroianni C M, Delia S
Institute of Infectious Diseases, Università La Sapienza, Rome, Italy.
Int J Clin Pharmacol Res. 1994;14(5-6):157-63.
Infections of Rhodococcus equi, a well-known pathogen in animals which causes cavitated pneumonia similar to that caused by mycobacteria, were studied in three HIV-infected patients. This microorganism was isolated in the bronchoalveolar washings of two patients and in the sputum of the third. In two patients, Rh. equi represented the first clinical opportunistic manifestation of HIV disease. One patient died of concomitant Pneumocystis infection. The eradication of the microorganism occurred in two out of three patients. It was found that no isolates were resistant to erythromycin, claritromycin, rifampin, vancomycin, teicoplanin, imipenem, gentamycin or azithromycin (MIC values < or = 0.1 microgram/ml). Moreover, the quinolones (ciprofloxacin and ofloxacin) were found to be less effective, whereas neither the beta-lactam antibiotics nor chloramphenicol were effective therapy for this microrganism. At least two antimicrobial agents should be given contemporaneously to treat these infections for a period of up to several months. Our results suggest that the combinations erythromycin + rifampin or imipenem + teicoplanin are the most effective treatments in Rh. equi infections.
马红球菌是一种动物中常见的病原体，可引起与分枝杆菌所致类似的空洞性肺炎。我们对3例HIV感染患者的马红球菌感染情况进行了研究。该微生物在2例患者的支气管肺泡灌洗液以及第3例患者的痰液中被分离出来。在2例患者中，马红球菌是HIV疾病的首个临床机会性表现。1例患者死于合并的肺孢子菌感染。3例患者中有2例的微生物被根除。结果发现，分离菌株对红霉素、克拉霉素、利福平、万古霉素、替考拉宁、亚胺培南、庆大霉素或阿奇霉素均无耐药性（MIC值≤0.1微克/毫升）。此外，喹诺酮类药物（环丙沙星和氧氟沙星）疗效较差，而β-内酰胺类抗生素和氯霉素对该微生物均无治疗效果。治疗这些感染应同时给予至少两种抗菌药物，疗程长达数月。我们的结果表明，红霉素+利福平或亚胺培南+替考拉宁联合用药是治疗马红球菌感染最有效的方法。
