Merle-Melet M, Dossou-Gbete L, Maurer P, Meyer P, Lozniewski A, Kuntzburger O, Wéber M, Gérard A
Department of Infectious Diseases, Brabois Hospital University Center, Vandoeuvre, France.
J Infect. 1996 Sep;33(2):79-85. doi: 10.1016/s0163-4453(96)92929-1.
From June 1983 to January 1994, 22 adult patients with severe Listeria monocytogenes meningoencephalitis were observed in our Intensive Care Unit. Listeria monocytogenes was obtained in culture in cerebrospinal fluid or blood for every patient. Seven patients were treated with the combination ampicillin-aminoglycoside (group A) and 15 patients with the combination ampicillin (or amoxicillin)-cotrimoxazole (group A + C). Risk factors and gravity scores were similar in both groups. Failure of the 'gold standard' regimen (group A) was significantly higher (57%) compared to group A + C (6.7%) (P < 0.05). Mortality related to L. monocytogenes was 23.5% in group A compared to 6.7% in group A + C. Morbidity was reduced in group A + C (13.3%) compared to group A (60%) (P = 0.15). This unique study seems to demonstrate that amoxicillin-cotrimoxazole should be the most appropriate therapeutic regimen for Listeria meningoencephalitis.
1983年6月至1994年1月，我们的重症监护病房观察了22例患有严重单核细胞增生李斯特菌脑膜脑炎的成年患者。每位患者的脑脊液或血液培养物中均分离出单核细胞增生李斯特菌。7例患者接受氨苄西林-氨基糖苷类联合治疗（A组），15例患者接受氨苄西林（或阿莫西林）-复方新诺明联合治疗（A + C组）。两组的危险因素和病情严重程度评分相似。 “金标准”治疗方案（A组）的失败率（57%）显著高于A + C组（6.7%）（P < 0.05）。A组中与单核细胞增生李斯特菌相关的死亡率为23.5%，而A + C组为6.7%。与A组（60%）相比，A + C组的发病率有所降低（13.3%）（P = 0.15）。这项独特的研究似乎表明，阿莫西林-复方新诺明应该是治疗李斯特菌脑膜脑炎最合适的治疗方案。
