抗生素治疗后持续性伯氏疏螺旋体Sensu Lato感染:系统综述和实验动物模型的现有证据评估。

IF 19 1区 医学 Q1 MICROBIOLOGY
Clinical Microbiology Reviews Pub Date : 2022-12-21 Epub Date: 2022-10-12 DOI:10.1128/cmr.00074-22
Y L Verschoor, A Vrijlandt, R Spijker, R M van Hest, H Ter Hofstede, K van Kempen, A J Henningsson, J W Hovius
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引用次数: 2

摘要

莱姆病是由属于伯氏疏螺旋体群的螺旋体引起的,这些螺旋体由生活在北半球温带气候区的硬蜱传播。莱姆病的临床表现多种多样,可口服或静脉注射抗生素治疗。在一些患者中,经过推荐的抗生素治疗后,长期的衰弱症状可能会持续。这种持续症状的病因仍在争论中,其中一种假设是抗生素治疗后一部分螺旋体持续感染。在这里,我们回顾和评估了体内动物研究中关于抗生素治疗后伯氏菌持续感染的实验证据,重点是抗菌剂多西环素和头孢曲松。我们的综述表明,一些体内动物研究在抗生素治疗后发现了零星的阳性培养物。然而,这种培养物阳性似乎通常与抗生素治疗不足有关,一些研究中为数不多的阳性培养物在其他研究中无法复制。总的来说,目前动物研究的结果没有提供足够的证据证明经过适当的抗生素治疗后,有活力和传染性的螺旋体仍然存在。相反,在这些动物研究中经常检测到疏螺旋体核酸,因此在抗生素治疗后可能会持续存在。我们提出,研究人类莱姆病抗生素治疗后持续抱怨的发病机制应该是首要任务,但未来的研究肯定也应该集中在抗生素治疗后除了持续性伯氏菌感染之外的其他解释上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Persistent Borrelia burgdorferi Sensu Lato Infection after Antibiotic Treatment: Systematic Overview and Appraisal of the Current Evidence from Experimental Animal Models.

Lyme borreliosis is caused by spirochetes belonging to the Borrelia burgdorferi sensu lato group, which are transmitted by Ixodes tick species living in the temperate climate zones of the Northern Hemisphere. The clinical manifestations of Lyme borreliosis are diverse and treated with oral or intravenous antibiotics. In some patients, long-lasting and debilitating symptoms can persist after the recommended antibiotic treatment. The etiology of such persisting symptoms is under debate, and one hypothesis entails persistent infection by a subset of spirochetes after antibiotic therapy. Here, we review and appraise the experimental evidence from in vivo animal studies on the persistence of B. burgdorferi sensu lato infection after antibiotic treatment, focusing on the antimicrobial agents doxycycline and ceftriaxone. Our review indicates that some in vivo animal studies found sporadic positive cultures after antibiotic treatment. However, this culture positivity often seemed to be related to inadequate antibiotic treatment, and the few positive cultures in some studies could not be reproduced in other studies. Overall, current results from animal studies provide insufficient evidence for the persistence of viable and infectious spirochetes after adequate antibiotic treatment. Borrelial nucleic acids, on the contrary, were frequently detected in these animal studies and may thus persist after antibiotic treatment. We put forward that research into the pathogenesis of persisting complaints after antibiotic treatment for Lyme borreliosis in humans should be a top priority, but future studies should most definitely also focus on explanations other than persistent B. burgdorferi sensu lato infection after antibiotic treatment.

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来源期刊
Clinical Microbiology Reviews
Clinical Microbiology Reviews 医学-微生物学
CiteScore
54.20
自引率
0.50%
发文量
38
期刊介绍: Clinical Microbiology Reviews (CMR) is a journal that primarily focuses on clinical microbiology and immunology.It aims to provide readers with up-to-date information on the latest developments in these fields.CMR also presents the current state of knowledge in clinical microbiology and immunology.Additionally, the journal offers balanced and thought-provoking perspectives on controversial issues in these areas.
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