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פותח על ידי קלירמאש פתרונות בע"מ -
Why do we fail with penicillin in the treatment of group A streptococcus infections?
Year:
1999
Source of publication :
Annals of Medicine
Authors :
סלע, שלמה
;
.
Volume :
31
Co-Authors:
Sela, S., Department of Human Microbiology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel, Department of Human Microbiology, Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
Barzilai, A., Pediatric Infectious Diseases Unit, Chaim Sheba Medical Center, Tel-Hashomer Hospital, Tel-Aviv, Israel
Facilitators :
From page:
303
To page:
307
(
Total pages:
5
)
Abstract:
Acute pharyngotonsillitis caused by β-haemolytic group A streptococcus (GAS) is a common childhood disease. Phenoxymethyl penicillin remains the drug of choice, as no resistance has been reported so far. Nevertheless, the failure of penicillin to eradicate streptococci from the throat occurs in up to 35% of patients with pharyngotonsillitis, and might present clinical concern. Various explanations have been proposed over the years to account for this perplexing phenomenon. Among these are coexistence of oropharyngeal β-lactamase-producing bacteria that degrade penicillin, growth interference by aerobic and anaerobic commensals, penicillin tolerance, reinfection, and poor antibiotic compliance. Although GAS has been considered an extracellular pathogen, recent studies have demonstrated that strains of this bacterium can internalize epithelial cells both in vitro and in vivo. The intracellular niche may protect the bacterium from penicillin that does not gain high intracellular concentration. In support of this hypothesis, GAS strains were shown to survive 4-7 days inside cultured epithelial cells. In addition, it was found that GAS strains isolated from patients with eradication failure harbour the internalization-associated gene, prtF1/sfbI, in higher prevalence than do strains recovered from patients with successful eradication. Thus, internalization and intracellular survival represent a novel explanation for penicillin eradication failure.
Note:
Related Files :
Editorial
epithelium cell
human
patient compliance
Penicillin Resistance
penicillin v
reinfection
Streptococcus pyogenes
עוד תגיות
תוכן קשור
More details
DOI :
Article number:
Affiliations:
Database:
סקופוס
Publication Type:
מאמר מערכת
;
.
Language:
אנגלית
Editors' remarks:
ID:
19300
Last updated date:
02/03/2022 17:27
Creation date:
16/04/2018 23:27
Scientific Publication
Why do we fail with penicillin in the treatment of group A streptococcus infections?
31
Sela, S., Department of Human Microbiology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel, Department of Human Microbiology, Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
Barzilai, A., Pediatric Infectious Diseases Unit, Chaim Sheba Medical Center, Tel-Hashomer Hospital, Tel-Aviv, Israel
Why do we fail with penicillin in the treatment of group A streptococcus infections?
Acute pharyngotonsillitis caused by β-haemolytic group A streptococcus (GAS) is a common childhood disease. Phenoxymethyl penicillin remains the drug of choice, as no resistance has been reported so far. Nevertheless, the failure of penicillin to eradicate streptococci from the throat occurs in up to 35% of patients with pharyngotonsillitis, and might present clinical concern. Various explanations have been proposed over the years to account for this perplexing phenomenon. Among these are coexistence of oropharyngeal β-lactamase-producing bacteria that degrade penicillin, growth interference by aerobic and anaerobic commensals, penicillin tolerance, reinfection, and poor antibiotic compliance. Although GAS has been considered an extracellular pathogen, recent studies have demonstrated that strains of this bacterium can internalize epithelial cells both in vitro and in vivo. The intracellular niche may protect the bacterium from penicillin that does not gain high intracellular concentration. In support of this hypothesis, GAS strains were shown to survive 4-7 days inside cultured epithelial cells. In addition, it was found that GAS strains isolated from patients with eradication failure harbour the internalization-associated gene, prtF1/sfbI, in higher prevalence than do strains recovered from patients with successful eradication. Thus, internalization and intracellular survival represent a novel explanation for penicillin eradication failure.
Scientific Publication
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