Ahmed K, Kawakami K, Watanabe K, Mitsushima H, Nagatake T, Matsumoto K
Department of Internal Medicine, Nagasaki University, Japan.
Clin Infect Dis. 1995 Jan;20(1):41-6. doi: 10.1093/clinids/20.1.41.
From January 1986 through February 1993, there were 16 episodes of respiratory infection due to Corynebacterium pseudodiphtheriticum in 13 patients. The ages of patients ranged from 24 to 77 years; the ratio of male to female patients was 3:1. One patient had three episodes of infection, and another patient had two. In one patient, who died of disseminated intravascular coagulation, the level of IgG was low. One patient was receiving prednisolone when the infection occurred. In two cases a mixed infection with Streptococcus pneumoniae was noted. Sputum cultures yielded C. pseudodiphtheriticum (> or = 10(7) cfu/mL). An increased neutrophil response in the sputum of infected patients was observed. Gram staining and electron microscopy of sputum showed phagocytosis of C. pseudodiphtheriticum by the neutrophils. ELISAs also showed an increase in the level of immunoglobulin against C. pseudodiphtheriticum after infection. Tests for determination of MICs of antibiotics revealed that C. pseudodiphtheriticum isolates were susceptible to ampicillin, amoxycillin/clavulanic acid, cefazolin, cefuroxime, ceftazidime, and imipenem. All strains were resistant to nalidixic acid; borderline susceptibility to ofloxacin, norfloxacin, and ciprofloxacin was noted. We suggest the use of beta-lactam antibiotics in the treatment of infection with C. pseudodiphtheriticum.
1986年1月至1993年2月，13例患者发生了16次由假白喉棒状杆菌引起的呼吸道感染。患者年龄在24岁至77岁之间；男女患者比例为3:1。1例患者发生了3次感染，另1例患者发生了2次感染。1例死于弥散性血管内凝血的患者IgG水平较低。1例患者在感染发生时正在接受泼尼松龙治疗。2例患者发现合并肺炎链球菌感染。痰培养分离出假白喉棒状杆菌（≥10⁷cfu/mL）。观察到感染患者痰液中的中性粒细胞反应增强。痰液的革兰氏染色和电子显微镜检查显示中性粒细胞对假白喉棒状杆菌的吞噬作用。酶联免疫吸附测定（ELISA）也显示感染后针对假白喉棒状杆菌的免疫球蛋白水平升高。抗生素最低抑菌浓度（MIC）测定试验表明，假白喉棒状杆菌分离株对氨苄西林、阿莫西林/克拉维酸、头孢唑林、头孢呋辛、头孢他啶和亚胺培南敏感。所有菌株对萘啶酸耐药；对氧氟沙星、诺氟沙星和环丙沙星有临界敏感性。我们建议使用β-内酰胺类抗生素治疗假白喉棒状杆菌感染。
