Calame W, Douwes-Idema A E, van den Barselaar M T, van Furth R, Mattie H
Department of Infectious Diseases, University Hospital, Leiden, The Netherlands.
J Infect. 1994 Jul;29(1):53-66. doi: 10.1016/s0163-4453(94)95087-3.
The effect of cytostatic treatment on the cellular defence and the efficacy of treatment with ceftriaxone in Klebsiella pneumoniae pneumonia was studied. Mice, made monocytopenic and granulocytopenic by cyclophosphamide or monocytopenic by etoposide, were infected intratracheally with K. pneumoniae (approximately 10(4) CFU) and then treated with ceftriaxone. At various intervals, the numbers of bacteria in the broncho-alveolar lavage (BAL) fluid and in lungs homogenised after lavage were determined. Cyclophosphamide reduced the numbers of granulocytes in the BAL fluid significantly but reduced only slightly the number of alveolar macrophages at the time of inoculation, 12 and 15 h later. The number of CFU in cyclophosphamide-treated mice was higher than that in controls, being significant in the homogenised lungs at 15 h after infection. In etoposide-treated mice, the numbers of alveolar phagocytes in BAL did not differ from those in control mice, whereas the number of bacteria was lower (only significantly in BAL fluid at 15 h after infection) than that in the controls. In this short experimental infection cytostatic treatment did not affect the outgrowth of Klebsiella pneumoniae substantially or the efficacy of treatment with ceftriaxone.
研究了细胞毒性治疗对细胞防御的影响以及头孢曲松治疗肺炎克雷伯菌肺炎的疗效。通过环磷酰胺使小鼠单核细胞减少和粒细胞减少,或通过依托泊苷使小鼠单核细胞减少,然后经气管内感染肺炎克雷伯菌(约10⁴CFU),随后用头孢曲松治疗。在不同时间间隔,测定支气管肺泡灌洗(BAL)液和灌洗后肺匀浆中的细菌数量。环磷酰胺显著降低了BAL液中的粒细胞数量,但在接种时、12小时和15小时后仅轻微降低了肺泡巨噬细胞的数量。环磷酰胺治疗的小鼠中的CFU数量高于对照组,在感染后15小时肺匀浆中差异显著。在依托泊苷治疗的小鼠中,BAL中的肺泡吞噬细胞数量与对照小鼠无差异,而细菌数量低于对照组(仅在感染后15小时BAL液中差异显著)。在这种短期实验性感染中,细胞毒性治疗对肺炎克雷伯菌的生长或头孢曲松的治疗效果没有实质性影响。