脓肿分枝杆菌的菌种鉴定及药敏试验分析
[The analysis of species identification and susceptibility testing of Mycobacterium abscessus].
作者信息
Nie Wenjuan, Duan Hongfei, Huang Hairong, Lu Yu, Chu Naihui
机构信息
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China.
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China. Email:
出版信息
Zhonghua Jie He He Hu Xi Za Zhi. 2014 Jul;37(7):517-21.
OBJECTIVES
To evaluate the method of differentiating Mycobacterium abscessus subsp. abscessus (subsp. M. abscessus) from Mycobacterium abscessus subsp. massiliense (subsp. M. massiliense), and to investigate the activity of different antibiotics in vitro.
METHODS
Sixty Mycobacterium abscessus (M. abscessus) isolates previously identified by using 16S rRNA sequence, were identified by comparative sequence analysis of rpoB and hsp65, and were divided into subsp. M. abscessus and subsp. M. massiliense. Two subspecies' resistant proportions were compared by chi-square test. Finally the relationship between clarithromycin resistance and erm(41) was analyzed.
RESULTS
Of all the 60 M. abscessus isolates, 65% (39/60) belonged to subsp. M. abscessus, 35% (21/60) belonged to subsp. M. massiliense. 97% (38/39) subsp. M. abscessus and 95% (20/21) subsp. M. massiliense were susceptible to amikacin. 92% (36/39) subsp. M. abscessus and 95% (20/21) subsp. M. massiliense were susceptible to azithromycin. 74% (29/39) subsp. M. abscessus and 67% (14/21) subsp. M. massiliense were susceptible to imipenem. 46% (18/39) subsp. M. abscessus and 76% (16/21) subsp. M. massiliense were moderately susceptible to cefoxitin. 82% (32/39) subsp. M. abscessus were resistant to clarithromycin, and 95% (20/21) subsp. M. massiliense were susceptible to clarithromycin. Of all the 28 subsp. M. abscessus isolates which were sequenced suscessfully, 23 isolates were resistant to clarithromycin, and 22 isolates in them had T28 in erm(41), and the rest one had C28 in erm(41). However, all the 5 subsp. M. abscessus isolates which were susceptible to clarithromycin had C28 in erm(41).
CONCLUSIONS
M. abscessus can be divided into subsp. M. abscessus and subsp. M. massiliense by using rpoB and hsp65. Amikacin, azithromycin and imipenem showed excellent inhibition activity against M. abscessus in vitro. Cefoxitin also showed a good inhibition activity. Clarithromycin had a poor inhibition activity against subsp. M. abscessus, but a good inhibition activity against subsp. M. massiliense. Erm(41) was related to clarithromycin resistance.
目的
评估区分脓肿分枝杆菌脓肿亚种（脓肿分枝杆菌亚种）与马赛分枝杆菌脓肿亚种（马赛分枝杆菌亚种）的方法，并研究不同抗生素的体外活性。
方法
对先前通过16S rRNA序列鉴定的60株脓肿分枝杆菌分离株，通过rpoB和hsp65的比较序列分析进行鉴定，并分为脓肿分枝杆菌亚种和马赛分枝杆菌亚种。采用卡方检验比较两个亚种的耐药比例。最后分析克拉霉素耐药性与erm(41)之间的关系。
结果
在所有60株脓肿分枝杆菌分离株中，65%（39/60）属于脓肿分枝杆菌亚种，35%（21/60）属于马赛分枝杆菌亚种。97%（38/39）的脓肿分枝杆菌亚种和95%（20/21）的马赛分枝杆菌亚种对阿米卡星敏感。92%（36/39）的脓肿分枝杆菌亚种和95%（20/21）的马赛分枝杆菌亚种对阿奇霉素敏感。74%（29/39）的脓肿分枝杆菌亚种和67%（14/21）的马赛分枝杆菌亚种对亚胺培南敏感。46%（18/39）的脓肿分枝杆菌亚种和76%（16/21）的马赛分枝杆菌亚种对头孢西丁中度敏感。82%（32/39）的脓肿分枝杆菌亚种对克拉霉素耐药，而95%（20/21）的马赛分枝杆菌亚种对克拉霉素敏感。在所有成功测序的28株脓肿分枝杆菌亚种分离株中，23株对克拉霉素耐药，其中22株在erm(41)中有T28，其余1株在erm(41)中有C28。然而，所有5株对克拉霉素敏感的脓肿分枝杆菌亚种分离株在erm(41)中均有C28。
结论
利用rpoB和hsp65可将脓肿分枝杆菌分为脓肿分枝杆菌亚种和马赛分枝杆菌亚种。阿米卡星、阿奇霉素和亚胺培南在体外对脓肿分枝杆菌显示出优异的抑制活性。头孢西丁也显示出良好的抑制活性。克拉霉素对脓肿分枝杆菌亚种的抑制活性较差，但对马赛分枝杆菌亚种的抑制活性良好。erm(41)与克拉霉素耐药性有关。
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