摘要
目的分析100株胞内分枝杆菌临床株耐药谱及耐药相关基因,为治疗胞内分枝杆菌提供科学依据。方法对来自全国9家医院,保存于北京胸科医院细菌免疫实验室并初步鉴定为胞内分枝杆菌的100株临床株进行13种药物的药物敏感实验并对克拉霉素和阿米卡星耐药的临床株进行耐药相关突变位点的分析。结果100株胞内分枝杆菌临床分离株药物敏感性实验显示,克拉霉素,阿米卡星,利奈唑胺对胞内分枝杆菌有很好的抗菌活性。耐药率分别为11%(11/100),13%(13/100)和35%(35/100)。暂未发现与克拉霉素和阿米卡星耐药相关的突变位点。在胞内分枝杆菌肺病患者中以老年男性患者为多见,合并症以慢性阻塞性肺病与支气管扩张为主。结论胞内分枝杆菌对各种药物的敏感性有差异,因此临床治疗前应进行耐药性检测,以实现个性化治疗。
Objective To investigate the drug resistance profiles and drug resistance-related genes of 100 clinicalisolates strains of Mycobacteria intracellular in Chinaand toprovide scientific basis for the treatment of M.intracellular pulmonary disease.Methods A total of 100 M.intracellular clinical strains stored at the department of bacteriology and immunology of Beijing Chest Hospital were finally included.All strains were isolated from respiratory specimens of suspected tuberculosis or NTM patients in nine TB specialized hospitals.The minimal inhibitory concentration(MIC)of strains to 13 drugs was tested.Strains resistant to clarithromycin and amikacin werescreenedand the mutated sites of drug-resistant genes of rrl and rrswere tested.In addition,The demographic and clinical characteristics of patients with NTM lung diseases caused by M.intracellularwere analyzed.Results The drug susceptibility testing of 100 clinical isolates of M.intracellularindicated that Clarithromycin,Amikacin and Linezolid had good antibacterial activity againstthem.The drug resistant rates of M.intracellular to Clarithromycin,Amikacin and Linezolid were 11%(11/100),13%(13/100)and 35%(35/100),respectively.Clarithromycin,Amikacin and Linezolid demonstrated in vitro antimicrobial activity against most of M.intracellulareisolates.Strains resistant to Clarithromycin and Amikacin had no mutation sites associated with known drug resistance in genes of rrl and rrs.Clinical cases of M.intracellularlung diseases were similar to be found in the elderly malesand patients with chronic obstructive pulmonary disease and bronchiectasis comorbidity.Conclusion Drug resistance profiles of M.intracellularlungvaried a lot Objective To investigate the drug resistance profiles and drug resistance-related genes of 100 clinicalisolates strains of Mycobacteria intracellular in Chinaand toprovide scientific basis for the treatment of M.intracellular pulmonary disease.Methods A total of 100 M.intracellular clinical strains stored at the department of bacteriology and immunology of Beijing Chest Hospital were finally included.All strains were isolated from respiratory specimens of suspected tuberculosis or NTM patients in nine TB specialized hospitals.The minimal inhibitory concentration(MIC)of strains to 13 drugs was tested.Strains resistant to clarithromycin and amikacin werescreenedand the mutated sites of drug-resistant genes of rrl and rrswere tested.In addition,The demographic and clinical characteristics of patients with NTM lung diseases caused by M.intracellularwere analyzed.Results The drug susceptibility testing of100 clinical isolates of M.intracellularindicated that Clarithromycin,Amikacin and Linezolid had good antibacterial activity againstthem.The drug resistant rates of M.intracellular to Clarithromycin,Amikacin and Linezolid were 11%(11/100),13%(13/100)and 35%(35/100),respectively.Clarithromycin,Amikacin and Linezolid demonstrated in vitro antimicrobial activity against most of M.intracellulareisolates.Strains resistant to Clarithromycin and Amikacin had no mutation sites associated with known drug resistance in genes of rrl and rrs.Clinical cases of M.intracellularlung diseases were similar to be found in the elderly malesand patients with chronic obstructive pulmonary disease and bronchiectasis comorbidity.Conclusion Drug resistance profiles of M.intracellularlungvaried a lot indifferent drugs,thus drug susceptibility testing should be conducted prior to clinical treatmentto guide tailored therapy.
作者
古丽比克·木拉提
郭灿
任卫聪
尚媛媛
逄宇
孔忠顺
麻斌喜
Gulibike Mulati;GUO Can;REN Weicong;SHANG Yuanyuan;PANG Yu;KONG Zhongshun;MA Bingxi(The Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi,830049,China;Beijing Chest Hospital,Capital Medical University,Beijing,100000,China)
出处
《新疆医学》
2023年第5期507-511,共5页
Xinjiang Medical Journal
基金
北京市临床重点专科项目(项目编号:ZYLX202122)
关键词
胞内分枝杆菌
微生物敏感性试验
抗药性
Mycobacteria intracellular
Microbial sensitivity tests
Drug resistance
作者简介
古丽比克·木拉提,女,主管检验师,研究方向:结核病实验室诊断;通信作者:麻斌喜,男,硕士,主任药师,研究方向:药学,公共卫生学。E-mail:1611223648@qq.com。,中共党员,主任药师,硕士研究生导师。现任新疆医科大学第八附属医院党委委员、副院长。担任中国防痨协会常务理事、中国防痨协会结核病转化医学分会副主任委员、中华医学会结核病学分会委员、北京结核病诊疗技术创新联盟药事工作委员会副主任委员、中国防痨协会学术工作委员会委员、《中国防痨杂志》编委、新疆医学会理事、新疆医学会医疗事故技术鉴定专家库成员。近年来主持参与多项国家级合作项目、国家自然科学基金项目、新疆维吾尔自治区科研项目,国家科技重大专项,中国科协“一带一路”国际科技组织合作平台建设项目,自治区科技厅区域协同创新专项(上海合作组织科技伙伴计划)项目。新疆医学会结核病学专业委员会主任委员
