Cullmann W
Klinisch-Chemisches Institut, Bürgerhospital Stuttgart.
Med Klin (Munich). 1997 Mar 15;92(3):162-6. doi: 10.1007/BF03043274.
It is more than a century ago that Moraxella catarrhalis was discovered and described in some detail. However, it was not until the last decade that M. catarrhalis was recognized as a facultative pathogen, namely in otitis media (predominantly in children), sinusitis and nosocomial pneumonia in the group of elderly, debilitated patients. Liberation of endotoxin, histamine, and chemotactically active factors can be considered the major pathogenicity factors. The pathogen can protect itself, on the one hand by binding of the Clq subcomponent of the complement system followed by subsequent formation of a functionally inactive complex with Cl, and on the other hand by inactivation of the terminal (lytic) complement complexes by means of a specific protein on the surface of the outer cell wall. Routine diagnostic procedures require, above all, culture of the pathogen: up to now the detection of specific IgA-antibodies has not been routinely available. More than half of the clinical isolates are known to exhibit beta-lactamase production (BRO-enzymes). This is the reason why combinations of a penicillin compound with a beta-lactamase inhibitor, the group of the newer cephalosporins (including the orally active ones), doxycycline and the macrolides are therapeutically effective.
莫拉克斯氏菌属卡他莫拉菌于一个多世纪前被发现并得到了较为详细的描述。然而，直到最近十年，卡他莫拉菌才被确认为兼性病原菌，即在中耳炎（主要见于儿童）、鼻窦炎以及老年体弱患者群体中的医院获得性肺炎中。内毒素、组胺和趋化活性因子的释放可被视为主要致病因素。该病原菌可通过以下方式进行自我保护：一方面，通过结合补体系统的Clq亚成分，随后与Cl形成功能失活的复合物；另一方面，借助外细胞壁表面的一种特定蛋白质使末端（溶解）补体复合物失活。常规诊断程序首先需要对病原菌进行培养：到目前为止，特异性IgA抗体的检测尚未常规开展。已知超过一半的临床分离株可产生β-内酰胺酶（BRO酶）。这就是青霉素类化合物与β-内酰胺酶抑制剂、新型头孢菌素类（包括口服活性头孢菌素）、强力霉素和大环内酯类药物联合使用具有治疗效果的原因。
