Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Int J Antimicrob Agents. 2010 Feb;35(2):169-73. doi: 10.1016/j.ijantimicag.2009.09.023. Epub 2009 Dec 16.
In this study, 2275 clinical isolates of 49 species of non-tuberculous mycobacteria isolated in The Netherlands were subjected to standardised drug susceptibility testing using the Middlebrook 7H10 agar dilution method. Clarithromycin and rifabutin were most active, with 87% and 83% of all isolates, respectively, being susceptible. Susceptibility to ciprofloxacin (44%) and amikacin (32%) was limited and was mostly restricted to Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium fortuitum and phylogenetically related species. Susceptibility to isoniazid (0.5%), rifampicin (37%), ethambutol (35%) and streptomycin (33%) was rare; susceptibility to cycloserine, clofazimine and prothionamide was generally restricted to slow growers, although prothionamide also had activity against M. fortuitum and related species. Significant discrepancies between in vitro and in vivo activity exist. To improve the utility of drug susceptibility testing, the selection of drugs should be changed to more drugs with proven clinical efficacy correlating with in vitro susceptibility.
在这项研究中，对在荷兰分离的 49 种非结核分枝杆菌的 2275 株临床分离株进行了标准化药物敏感性测试，使用 Middlebrook 7H10 琼脂稀释法。克拉霉素和利福布汀最活跃，分别有 87%和 83%的分离株敏感。对环丙沙星（44%）和阿米卡星（32%）的敏感性有限，主要限于堪萨斯分枝杆菌、偶发分枝杆菌、脓肿分枝杆菌和系统发育相关的物种。异烟肼（0.5%）、利福平（37%）、乙胺丁醇（35%）和链霉素（33%）的敏感性罕见；对环丝氨酸、氯法齐明和丙硫异烟胺的敏感性通常仅限于生长缓慢的分枝杆菌，尽管丙硫异烟胺对脓肿分枝杆菌和相关物种也有活性。体外和体内活性之间存在显著差异。为了提高药物敏感性测试的实用性，应选择具有与体外敏感性相关的已证实临床疗效的更多药物进行药物敏感性测试。
