多药治疗后麻风病患者的持留菌研究

Persister studies in leprosy patients after multi-drug treatment.

作者信息

Gupta U D, Katoch K, Singh H B, Natrajan M, Katoch V M

机构信息

Central JALMA Institute for Leprosy and Other Mycobacterial Diseases (ICMR), Tajganj, Agra 282001, India.

出版信息

Int J Lepr Other Mycobact Dis. 2005 Jun;73(2):100-4.

PMID:16830652

Abstract

Cutaneous biopsies were collected from leprosy patients who attended the out-patient department of the Institute for treatment at different intervals, i.e., 12 months, 18 months, 24 months, 36 months, and more after beginning the multi-drug treatment therapy (M.D.T.). The patients belonged to the two drug regimens; (i) standard multibacillary (MB) M.D.T. after 12, 24, and 36 months; or (ii) standard M.D.T. + Minocycline 100 mg once a month (supervised) + Ofloxacin 400 mg once a month supervised for 12 months Biopsies were processed for mouse footpad inoculation and for estimating ATP levels by bioluminescence assay as per established methods. Viable bacilli were observed in 23.5% up to 1 year, 7.1% at 2 years, and in 3.84% at 3 years of M.D.T. by MFP and 29.4%, 10.7%, and 3.84% by ATP assay in the M.D.T. group at the same time period, respectively, but not in M.D.T. + Minocycline + Ofloxacin group after one year. The overall percentage of persisters was 5.55% by MFP and 7.14% by ATP assay up to 3 years of treatment.

摘要

从在研究所门诊部接受治疗的麻风病患者身上，在开始多药联合治疗（M.D.T.）后的不同时间间隔，即12个月、18个月、24个月、36个月及更长时间，采集皮肤活检样本。患者分为两种治疗方案：（i）标准多菌型（MB）M.D.T.，分别在12个月、24个月和36个月后进行；或（ii）标准M.D.T. + 米诺环素100毫克每月一次（监督服用）+ 氧氟沙星400毫克每月一次监督服用12个月。按照既定方法，对活检样本进行处理，用于小鼠足垫接种以及通过生物发光测定法估计ATP水平。通过小鼠足垫接种法（MFP），在M.D.T.治疗1年时，23.5%的样本中观察到活菌，2年时为7.1%，3年时为3.84%；在同一时期，通过ATP测定法，M.D.T.组中活菌比例分别为29.4%、10.7%和3.84%，但在M.D.T. + 米诺环素 + 氧氟沙星组中，1年后未观察到活菌。在长达3年的治疗中，通过MFP法检测到的持续菌总体比例为5.55%，通过ATP测定法为7.14%。