Villar H, Jugo M, Farinati A
Cátedra de Infectología y Microbiología Clínica, Universidad Católica Argentina, Riobamba.
Enferm Infecc Microbiol Clin. 1994 Oct;12(8):385-9.
Evaluation of the incidence, tolerance and the bactericidal activity against penicillin, ampicillin, cefotaxime, gentamicin and the combination of penicillin plus gentamicin, ampicillin plus gentamicin, cefotaxime plus gentamicin and cefotaxime plus ampicillin in 22 clinical isolates of Streptococcus agalactiae.
Killing curves were performed. The concentrations of antibiotics was selected taking into account its level in cerebrospinal fluid.
We detected 5 (22.7%) tolerant strains to penicillin and ampicillin and 2 of them (9.0%) were also tolerant to cefotaxime. Bactericidal activity was seen in a 100% of the strains against the association penicillin plus gentamicin, ampicillin plus gentamicin and cefotaxime plus gentamicin, being greater than the bactericidal activity against cefotaxime (77.3%), penicillin, ampicillin and cefotaxime plus ampicillin (54.5% respectively).
Considering the high incidence of tolerance and the deficient bactericidal activity of the beta-lactam antibiotics against tolerant and no tolerant strains, it seems necessary to include gentamicin in the treatment of Streptococcus agalactiae severe infections. Several studies of experimental models must be performed to verify in vivo, the in vitro results.
评估22株无乳链球菌临床分离株对青霉素、氨苄西林、头孢噻肟、庆大霉素以及青霉素加庆大霉素、氨苄西林加庆大霉素、头孢噻肟加庆大霉素和头孢噻肟加氨苄西林的发生率、耐受性及杀菌活性。
绘制杀菌曲线。根据抗生素在脑脊液中的水平选择其浓度。
我们检测到5株（22.7%）对青霉素和氨苄西林耐受的菌株，其中2株（9.0%）也对头孢噻肟耐受。100%的菌株对青霉素加庆大霉素、氨苄西林加庆大霉素和头孢噻肟加庆大霉素的联合用药表现出杀菌活性，大于对头孢噻肟（77.3%）、青霉素、氨苄西林以及头孢噻肟加氨苄西林（分别为54.5%）的杀菌活性。
考虑到耐受性的高发生率以及β-内酰胺类抗生素对耐受和非耐受菌株杀菌活性不足，在无乳链球菌严重感染的治疗中加入庆大霉素似乎是必要的。必须进行多项实验模型研究以在体内验证体外结果。
