Gayraud M, Scavizzi M R, Mollaret H H, Guillevin L, Hornstein M J
Service de Médecine Interne, Hôpital Avicenne, Université Paris Nord, Bobigny, France.
Clin Infect Dis. 1993 Sep;17(3):405-10. doi: 10.1093/clinids/17.3.405.
Of 53 documented cases of Yersinia enterocolitica septicemia reported to the French national registry between 1985 and 1991, 43 files contained sufficient information on antibiotic treatment to be analyzed retrospectively. All patients had at least two positive cultures of blood collected before the initiation of treatment. All strains were susceptible in vitro to the antibiotics that are usually active against gram-negative rods except for older beta-lactam agents (i.e., aminopenicillins and first-generation cephalosporins). No multiresistant strain was isolated. Only four (7.5%) of the 53 patients died. Aminopenicillins, first-generation cephalosporins, and--when prescribed alone--amoxicillin/clavulanate were not effective. Third-generation cephalosporins, most often used in combination with other antibiotics, were successful in 85% of cases. Fluoroquinolones--alone or in combination--cured all of 15 infections, with patients improving rapidly and becoming apyretic within 1-4 days. These agents therefore seem to constitute the best treatment.
1985年至1991年间向法国国家登记处报告的53例小肠结肠炎耶尔森菌败血症确诊病例中，43份档案包含足够的抗生素治疗信息，可供进行回顾性分析。所有患者在开始治疗前至少有两份血培养呈阳性。除了较老的β-内酰胺类药物（即氨基青霉素和第一代头孢菌素）外，所有菌株在体外对通常对革兰氏阴性杆菌有效的抗生素敏感。未分离出多重耐药菌株。53例患者中仅4例（7.5%）死亡。氨基青霉素、第一代头孢菌素以及单独使用的阿莫西林/克拉维酸无效。第三代头孢菌素最常与其他抗生素联合使用，85%的病例治疗成功。氟喹诺酮类药物单独使用或联合使用治愈了全部15例感染，患者迅速好转，在1 - 4天内退热。因此，这些药物似乎构成了最佳治疗方案。
