Miyasaka Tomomitsu, Kunishima Hiroyuki, Komatsu Mayumi, Tamai Kiyoko, Mitsutake Kotaro, Kanemitsu Keiji, Ohisa Yoshiharu, Yanagisawa Hideji, Kaku Mitsuo
Miroku Medical Laboratory Inc., 659-2 Innai, Saku-shi, Nagano 384-2201, Japan.
Int J Antimicrob Agents. 2007 Sep;30(3):255-8. doi: 10.1016/j.ijantimicag.2007.05.003. Epub 2007 Jul 9.
Antimicrobial therapy of Mycobacterium abscessus infection is difficult because there are relatively few effective treatment regimens and single-agent therapy frequently fails clinically. In light of the lack of data on the susceptibility profile of M. abscessus strains recovered from infections in Japan, the in vitro activity of imipenem in combination with clarithromycin, levofloxacin, moxifloxacin, minocycline, amikacin or tobramycin was investigated by the checkerboard method and compared with the combination amikacin and cefoxitin. The combination of imipenem with moxifloxacin, levofloxacin or clarithromycin had a higher synergistic and/or additive effect than amikacin and cefoxitin. A decrease in the MIC(90) value (minimum inhibitory concentration for 90% of the organisms) was observed in the presence of imipenem for clarithromycin, minocycline, levofloxacin and moxifloxacin. The data suggest that a combination regimen including imipenem may be a good choice in empirical treatment of M. abscessus infection.
脓肿分枝杆菌感染的抗菌治疗很困难，因为有效的治疗方案相对较少，且单药治疗在临床上常常失败。鉴于缺乏从日本感染中分离出的脓肿分枝杆菌菌株药敏谱的数据，采用棋盘法研究了亚胺培南与克拉霉素、左氧氟沙星、莫西沙星、米诺环素、阿米卡星或妥布霉素联合的体外活性，并与阿米卡星和头孢西丁联合进行比较。亚胺培南与莫西沙星、左氧氟沙星或克拉霉素联合具有比阿米卡星和头孢西丁更高的协同和/或相加作用。在亚胺培南存在的情况下，克拉霉素、米诺环素、左氧氟沙星和莫西沙星的MIC（90）值（90%菌株的最低抑菌浓度）出现下降。数据表明，包括亚胺培南的联合治疗方案可能是脓肿分枝杆菌感染经验性治疗的一个不错选择。
