Alba D, Torres E
Departamento de Medicina Interna, Hospital La Paz, Paseo de la Castellana, Madrid.
Rev Neurol. 1995 May-Jun;23(121):656-60.
Viridans Streptococci (VS) may cause meningitis although, in most cases, they are isolated as contaminants in CSF. However VS should not be systematically underestimated as contaminants in CSF without a suitable clinical and analytical evaluation. Meningitis as a result of VS is being diagnosed with increasing frequency, especially in new born babies. Classic predisposition factors and illnesses (traumatism, surgery and infection) have increased, one frequent pathogenic mechanism being rupture of the mucous membrane with subsequent meningitis. VS are normally sensitive to penicillin G. However VS may be resistant to penicillin (low affinity of PBP to penicillin) and cause serious infections, including meningitis. For this reason it is convenient to perform sensitivity tests on VS in vitro in isolation to determine the appropriate therapy.
草绿色链球菌(VS)可能会引发脑膜炎,尽管在大多数情况下,它们是作为脑脊液中的污染物被分离出来的。然而,在没有进行适当的临床和分析评估的情况下,不应将脑脊液中的VS系统性地低估为污染物。由VS导致的脑膜炎诊断频率日益增加,尤其是在新生儿中。典型的易感因素和疾病(创伤、手术和感染)有所增加,常见的致病机制之一是黏膜破裂继而引发脑膜炎。VS通常对青霉素G敏感。然而,VS可能对青霉素耐药(青霉素结合蛋白对青霉素的亲和力低)并导致包括脑膜炎在内的严重感染。因此,对分离出的VS进行体外药敏试验以确定合适的治疗方法是很有必要的。