Senol Güneş, Coşkun Meral, Gündüz Ayriz Tuba, Biçmen Can, Gayaf Mine, Ozsöz Ayşe
Izmir Göğüs Hastaliklari ve Cerrahisi Eğitim ve Araştirma Hastanesi, Mikrobiyoloji Laboratuvari, Izmir.
Mikrobiyol Bul. 2008 Oct;42(4):591-7.
Pyrazinamide (PZA) is one of primary drugs for antituberculous treatment. The aim of this study was to determine the rates of PZA resistance in multidrug-resistant (MDR) and susceptible Mycobacterium tuberculosis (MTB) strains isolated from patients who were admitted to our hospital. MDR strains have been isolated between 2005-2007 years, and susceptible strains were chosen randomly among the collection of the strains of the same period. MTB isolates were grown in BACTEC 960 full automatized broth system (Becton Dickinson, Sparks, MD) and Lowenstein-Jensen solid medium. Identification was done by radiometric BACTEC 460 NAP procedure. Antibiotic susceptibility testing against conventional anti-tuberculous drugs (streptomycin, isoniazide, rifampisin, etambutol) was performed by the radiometric BACTEC 460 system and PZA susceptibility was worked out by BD MGIT 960 PZA Kit (Becton Dickinson, Sparks, MD) with the use of 100.0 microg/ml critical concentrations of PZA. As a result, two of the 65 (3.1%) MTB susceptible strains and 16 of 63 (25.4%) MDR-MTB isolates were found resistant to PZA. In conclusion, due to the high PZA resistance rate in MDR-MTB isolates, susceptibility testing against PZA should be done in MDR-TB cases; however, since PZA resistance rate was low in new susceptible cases, it was thought that testing susceptibility of PZA is not necessary as a routine procedure in our region.
吡嗪酰胺(PZA)是抗结核治疗的主要药物之一。本研究的目的是确定从我院住院患者中分离出的耐多药(MDR)和敏感结核分枝杆菌(MTB)菌株对PZA的耐药率。MDR菌株于2005 - 2007年分离得到,敏感菌株从同一时期收集的菌株中随机选取。MTB分离株在BACTEC 960全自动肉汤系统(Becton Dickinson,斯帕克斯,马里兰州)和罗 - 琴固体培养基中培养。通过放射性BACTEC 460 NAP程序进行鉴定。采用放射性BACTEC 460系统对传统抗结核药物(链霉素、异烟肼、利福平、乙胺丁醇)进行药敏试验,使用BD MGIT 960 PZA试剂盒(Becton Dickinson,斯帕克斯,马里兰州),以100.0μg/ml的PZA临界浓度测定PZA药敏情况。结果,65株MTB敏感菌株中有2株(3.1%)对PZA耐药,63株MDR - MTB分离株中有16株(25.4%)对PZA耐药。总之,由于MDR - MTB分离株对PZA的耐药率较高,MDR - TB病例应进行PZA药敏试验;然而,由于新的敏感病例中PZA耐药率较低,在我们地区认为作为常规程序进行PZA药敏试验没有必要。