Hospital General Universitario de Elche, Elche (Alicante), Spain.
J Infect Chemother. 2010 Feb;16(1):64-7. doi: 10.1007/s10156-009-0008-1.
Interest in Mycobacterium fortuitum has increased since it was recognized as an emergent pathogen. The objective of this study was to screen a large number of drug combinations in order to evaluate the activity of classical and new potentially useful antibiotics against M. fortuitum. Twenty M. fortuitum clinical isolates were studied with 51 combinations of two drugs and 47 combinations of three drugs belonging to different families: fluoroquinolones, linezolid, macrolides, rifamycins, aminoglycosides, and carbapenems. Activity was determined in Mueller Hinton broth by seeing whether the cultures were negative after 4 days of incubation with the combination of antibiotics. The most active drugs were moxifloxacin and gatifloxacin, which were active against 15 of the 20 strains studied, followed by amikacin (14 of the 20). The combinations of gatifloxacin with rifampicin or rifabutin, moxifloxacin with rifampicin or amikacin, and ciprofloxacin with amikacin were the most useful against M. fortuitum, as they showed activity in 18 of the 20 strains studied. Linezolid, imipenem, and ertapenem showed poor activity in this experimental model when they were used on their own. Larger studies, both in vitro and in vivo, should be done to confirm the true usefulness of the new fluoroquinolones, alone or in combination, in the treatment of M. fortuitum.
自从偶然分枝杆菌被认为是一种新出现的病原体以来，人们对它的兴趣日益增加。本研究的目的是筛选大量药物组合，以评估经典和新的潜在有用抗生素对偶然分枝杆菌的活性。研究了 20 株偶然分枝杆菌临床分离株，使用了 51 种二药组合和 47 种三药组合，这些药物组合属于不同的家族：氟喹诺酮类、利奈唑胺、大环内酯类、利福霉素类、氨基糖苷类和碳青霉烯类。在 Mueller Hinton 肉汤中通过观察在含有抗生素的混合物孵育 4 天后培养物是否为阴性来确定活性。最有效的药物是莫西沙星和加替沙星，它们对研究的 20 株菌株中的 15 株有效，其次是阿米卡星（20 株中的 14 株）。加替沙星与利福平或利福布汀、莫西沙星与利福平或阿米卡星、环丙沙星与阿米卡星的组合对偶然分枝杆菌最有效，因为它们对研究的 20 株菌株中的 18 株显示出活性。利奈唑胺、亚胺培南和厄他培南在这种实验模型中单独使用时活性较差。应进行更大规模的体外和体内研究，以确认新型氟喹诺酮类药物单独或联合使用在治疗偶然分枝杆菌方面的真正用途。
