Riviera L, Dubini F, Bellotti M G
Institute of Microbiology, University of Catania, Italy.
New Microbiol. 1993 Apr;16(2):189-203.
L. monocytogenes can induce serious, life-threatening infections. Multiple clinical manifestations of the disease include neonatal and perinatal listeriosis, infections in adult immunocompromised patients as well as in normal hosts, with the CNS as the more frequent site involved. Many outbreaks are believed to be food-borne in origin, but there can be other means of transmission. The susceptibility of L. monocytogenes to different antimicrobial drugs is reviewed. Many drugs that are highly effective in vitro show only a moderate activity in vivo, due either to their poor ability to enter the phagocytes and destroy the engulfed bacteria, as with the beta-lactams, ampicillin and amoxicillin, or to their bacteriostatic rather than bactericidal activity, as with the fluoroquinolones, or their affinity for a serum glycoprotein, as with the macrolide antibiotics. The bacterial killing appears to be enhanced by some synergistic drug associations, the best therapeutic results being achieved by trimethoprim-cotrimoxazole and ampicillin plus gentamicin. Other more recent antimicrobial drugs and drug combinations are still under clinical evaluation.
单核细胞增生李斯特菌可引发严重的、危及生命的感染。该疾病的多种临床表现包括新生儿和围产期李斯特菌病、成年免疫功能低下患者以及正常宿主的感染，其中中枢神经系统是较常受累的部位。许多疫情被认为源于食源性传播，但也可能存在其他传播途径。本文综述了单核细胞增生李斯特菌对不同抗菌药物的敏感性。许多在体外高效的药物在体内仅表现出中等活性，这要么是因为它们进入吞噬细胞并杀灭被吞噬细菌的能力较差，如β-内酰胺类药物氨苄西林和阿莫西林；要么是因为它们具有抑菌而非杀菌活性，如氟喹诺酮类药物；要么是因为它们与血清糖蛋白的亲和力，如大环内酯类抗生素。某些药物联合使用具有协同作用，可增强细菌杀灭效果，其中甲氧苄啶-磺胺甲恶唑以及氨苄西林加庆大霉素的治疗效果最佳。其他一些较新的抗菌药物和药物组合仍在进行临床评估。
