Scheel O, Hoel T, Sandvik T, Berdal B P
Norwegian Defence Microbiological Laboratory, Oslo.
APMIS. 1993 Jan;101(1):33-6.
Some recently introduced antimicrobial agents have only been incompletely evaluated for use in Francisella tularensis infections. The present study evaluated the susceptibility pattern of Scandinavian human, rodent, and hare F. tularensis isolates with respect to a selection of traditional as well as recently introduced antimicrobial agents. All strains were resistant to the following beta-lactams: penicillin, cephalexin, cefuroxime, ceftazidime, aztreonam, imipenem, and meropenem with minimal inhibitory concentrations > 32 mg/l. Against macrolides, a mixed susceptibility/resistance pattern appeared. All strains were susceptible to gentamicin, chloramphenicol, doxycycline, and four quinolones. Since the quinolones showed the lowest MIC values, and in addition give a good intracellular penetration, we conclude that future drugs to consider against tularemia should definitely include this group of antibiotics. The outpatient mode of antibiotic treatment is especially relevant as the Scandinavian variant of F. tularensis infection is nonlethal, usually pustuloglandular, and not septicemic. Therefore, oral drugs must be sought, and the quinolone group also satisfies this requirement.
一些最近引入的抗菌药物在用于土拉弗朗西斯菌感染方面仅得到了不完全评估。本研究评估了斯堪的纳维亚地区人类、啮齿动物和野兔来源的土拉弗朗西斯菌分离株对一系列传统以及最近引入的抗菌药物的敏感性模式。所有菌株对以下β-内酰胺类药物耐药：青霉素、头孢氨苄、头孢呋辛、头孢他啶、氨曲南、亚胺培南和美罗培南，最低抑菌浓度>32mg/L。对于大环内酯类药物，出现了敏感/耐药的混合模式。所有菌株对庆大霉素、氯霉素、多西环素和四种喹诺酮类药物敏感。由于喹诺酮类药物显示出最低的最低抑菌浓度值，并且还具有良好的细胞内穿透力，我们得出结论，未来考虑用于治疗兔热病的药物肯定应包括这一类抗生素。抗生素门诊治疗模式尤其适用，因为斯堪的纳维亚地区的土拉弗朗西斯菌感染变体不致命，通常为脓疱腺型，且不发生败血症。因此，必须寻找口服药物，而喹诺酮类药物也满足这一要求。
