Pigrau C, Bartolome R, Almirante B, Planes A M, Gavalda J, Pahissa A
Infectious Diseases Service, Hospitals Vall d'Hebron, Universitat Autonoma, Barcelona, Spain.
Clin Infect Dis. 1997 Dec;25(6):1414-20. doi: 10.1086/516127.
From 1979 to 1996, 58 patients (mean age, 39.4 years) were treated for bacteremia due to Campylobacter species at the Hospitals Vall d'Hebron in Barcelona, Spain. Bacteremia was considered to be hospital acquired in 30% of these patients. Almost all the patients (93%) had underlying conditions; liver cirrhosis was the most frequent (34% of patients), and neoplasia, immunosuppressive therapy, and human immunodeficiency virus disease were also common. Of the 58 Campylobacter strains isolated, 81% were C. jejuni, 10% were Campylobacter species, 7% were C. fetus, and one (2%) was C. coli. Resistance rates were: cephalothin, 82%; co-trimoxazole, 79%; quinolones, 54%; ampicillin, 20%; amoxicillin/clavulanate, 4%; erythromycin, 7%; gentamicin, 0; and tetracyclines, 0. Even though the majority of patients were immunocompromised, mortality was low (10.5%), and only one patient relapsed. Because of the high level of resistance to the quinolones in Campylobacter species, these drugs should not be used as empirical treatment, at least in Spain. Although the macrolides remain the antibiotics of choice, amoxicillin/clavulanate may be an effective alternative therapy.
1979年至1996年期间，西班牙巴塞罗那的瓦尔德希伯伦医院对58例因弯曲杆菌属感染导致菌血症的患者（平均年龄39.4岁）进行了治疗。这些患者中有30%的菌血症被认为是医院获得性的。几乎所有患者（93%）都有基础疾病；肝硬化最为常见（占患者的34%），肿瘤、免疫抑制治疗和人类免疫缺陷病毒病也很常见。在分离出的58株弯曲杆菌菌株中，81%为空肠弯曲菌，10%为弯曲杆菌属，7%为胎儿弯曲菌，1株（2%）为大肠弯曲菌。耐药率分别为：头孢噻吩，82%；复方新诺明，79%；喹诺酮类，54%；氨苄西林，20%；阿莫西林/克拉维酸，4%；红霉素，7%；庆大霉素，0；四环素，0。尽管大多数患者免疫功能低下，但死亡率较低（10.5%），只有1例患者复发。由于弯曲杆菌属对喹诺酮类药物的耐药性较高，这些药物不应作为经验性治疗药物，至少在西班牙是这样。虽然大环内酯类药物仍然是首选抗生素，但阿莫西林/克拉维酸可能是一种有效的替代疗法。
