Heginbothom M L
Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK.
Int J Tuberc Lung Dis. 2001 Jun;5(6):539-45.
It is generally accepted that qualitative drug susceptibility tests established and validated for Mycobacterium tuberculosis are not applicable to opportunist (non-tuberculous) mycobacteria. Previous studies have shown that in vitro antimicrobial susceptibilities for opportunist mycobacteria, performed by the method of modal resistance (MR), correlate poorly with clinical response. Minimum inhibitory concentration (MIC) determination may provide better correlation with predicted clinical response than the conventional MR results.
To determine the relationship between quantitative in vitro sensitivity results for opportunist mycobacteria and their in vivo response to treatment.
MICs were performed radiometrically with the Bactec TB-460 system; 35 M. avium complex isolates, 29 isolates of M. malmoense and 16 isolates of M. xenopi were tested.
Susceptibility results were analysed in comparison with therapeutic outcome by Fisher's exact probability test. Only one significant association was found; in vitro resistance to ethambutol correlated with treatment failure for M. malmoense infections (P = 0.027). There were no other significant correlations between in vitro results and treatment outcome.
Prediction of treatment outcome from in vitro susceptibility tests continues to be a problem in infections with opportunist mycobacteria.
普遍认为，已建立并验证的针对结核分枝杆菌的定性药敏试验不适用于机会性（非结核性）分枝杆菌。以往研究表明，采用模式耐药（MR）方法对机会性分枝杆菌进行的体外抗菌药敏试验与临床反应的相关性较差。与传统的MR结果相比，最低抑菌浓度（MIC）测定可能与预测的临床反应具有更好的相关性。
确定机会性分枝杆菌的定量体外药敏结果与其体内治疗反应之间的关系。
使用Bactec TB - 460系统通过放射测量法测定MIC；对35株鸟分枝杆菌复合群分离株、29株马尔默分枝杆菌分离株和16株蟾蜍分枝杆菌分离株进行检测。
通过Fisher精确概率检验将药敏结果与治疗结果进行比较分析。仅发现一个显著关联；体外对乙胺丁醇耐药与马尔默分枝杆菌感染的治疗失败相关（P = 0.027）。体外结果与治疗结果之间无其他显著相关性。
对于机会性分枝杆菌感染，根据体外药敏试验预测治疗结果仍然是一个问题。
