Tee W, Mijch A, Wright E, Yung A
Victorian Infectious Diseases Reference Laboratory, Fairfield Hospital, Victoria, Australia.
Clin Infect Dis. 1995 Sep;21(3):634-8. doi: 10.1093/clinids/21.3.634.
Single-drug resistance to tetracycline, doxycycline, erythromycin, or fluoroquinolones in Campylobacter isolates recovered from humans has been documented worldwide. Multidrug resistance to these antibiotics is rare in Campylobacter jejuni. We report the sequential development of multidrug resistance in C. jejuni isolates from three patients who were infected with human immunodeficiency virus. Multiple isolates recovered from stool specimens from these patients were ribotyped, and antibiotic susceptibility profiles were determined. The results indicated that each patient was infected with a single strain of C. jejuni that had progressively acquired resistance to the antibiotics used during treatment. The emergence of resistant isolates appeared to correlate with clinical relapse. In these patients, campylobacter enteritis was prolonged, severe, and relapsing, and antimicrobial therapy was required. Once these first-line antibiotics become ineffective, few other antibiotics are available for treating patients with campylobacter enteritis. Acquisition of antibiotic resistance in C. jejuni is therefore of concern in these cases.
从人类身上分离出的弯曲杆菌菌株对四环素、强力霉素、红霉素或氟喹诺酮的单药耐药性在全球范围内都有记录。空肠弯曲杆菌对这些抗生素的多重耐药性很少见。我们报告了三例感染人类免疫缺陷病毒患者的空肠弯曲杆菌菌株中多重耐药性的相继出现。对从这些患者粪便标本中分离出的多个菌株进行了核糖分型，并确定了抗生素敏感性谱。结果表明，每位患者均感染了单一菌株的空肠弯曲杆菌，该菌株逐渐获得了对治疗期间使用的抗生素的耐药性。耐药菌株的出现似乎与临床复发相关。在这些患者中，弯曲杆菌肠炎病程延长、病情严重且反复发作，需要进行抗菌治疗。一旦这些一线抗生素失效，治疗弯曲杆菌肠炎的患者就几乎没有其他可用的抗生素了。因此，在这些病例中，空肠弯曲杆菌获得抗生素耐药性令人担忧。
