Rabella N, Otegui M, Labeaga R, Rodríguez P, Margall N, Gurguí M, Prats G
Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
Clin Infect Dis. 2002 Apr 15;34(8):1055-60. doi: 10.1086/339490. Epub 2002 Mar 11.
The in vitro susceptibility to acyclovir of 204 herpes simplex virus isolates from 165 immunocompromised patients treated at our hospital was determined by the cytopathic effect reduction assay. Approximately 95% of herpes simplex virus 1 and 73% of herpes simplex virus 2 isolates were inhibited by acyclovir at concentrations of <2 microgram/mL. From 8 patients (5%), an isolate with low susceptibility to acyclovir (50% inhibitory dose, >3 microgram/mL) was recovered. Medical records of 83 patients were reviewed. Lesions resolved in most of the patients, independent of treatment. Treatment failures were not always associated with isolation of an in vitro-resistant virus. On the contrary, when a virus with low susceptibility to acyclovir was isolated, resolution of the lesion was the rule. In 9 of 10 patients with subsequent recurrent episodes of disease, the susceptibility of the viruses isolated was similar to that of the first episode. Routine susceptibility testing in our geographic area is not encouraged because of the low incidence of acyclovir-resistant herpes simplex viruses.
通过细胞病变效应降低试验，测定了我院收治的165例免疫功能低下患者的204株单纯疱疹病毒分离株对阿昔洛韦的体外敏感性。在浓度<2微克/毫升时，约95%的单纯疱疹病毒1型和73%的单纯疱疹病毒2型分离株受到阿昔洛韦抑制。从8例患者（5%）中分离出对阿昔洛韦敏感性低（50%抑制剂量，>3微克/毫升）的毒株。回顾了83例患者的病历。大多数患者的病变得以消退，与治疗无关。治疗失败并不总是与体外耐药病毒的分离有关。相反，当分离出对阿昔洛韦敏感性低的病毒时，病变消退是常见情况。在随后10例疾病复发的患者中，有9例分离出的病毒敏感性与首次发作时相似。由于耐阿昔洛韦单纯疱疹病毒的发生率较低，不鼓励在我们所在地区进行常规敏感性检测。
