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韩国脓肿分枝杆菌和马赛分枝杆菌的药敏谱及对大环内酯类药物的诱导耐药性

The drug susceptibility profile and inducible resistance to macrolides of Mycobacterium abscessus and Mycobacterium massiliense in Korea.

作者信息

Kim Song Yee, Kim Chang-Ki, Bae Il Kwon, Jeong Seok Hoon, Yim Jae-Joon, Jung Ji Ye, Park Moo Suk, Kim Young Sam, Kim Se Kyu, Chang Joon, Kang Young Ae

机构信息

Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Laboratory Medicine, Korean Institute of Tuberculosis, Cheongju, Republic of Korea.

出版信息

Diagn Microbiol Infect Dis. 2015 Feb;81(2):107-11. doi: 10.1016/j.diagmicrobio.2014.10.007. Epub 2014 Oct 25.

Abstract

We conducted drug susceptibility testing (DST) against various antimicrobial agents, including new candidate drugs, and investigated the relationship between inducible resistance (IR) to macrolides and erm(41) gene in Mycobacterium abscessus complex. Sixty-two isolates of M. abscessus complex from 2 tertiary care hospitals in South Korea were tested against 10 antimicrobial agents. Thirty-five isolates were M. abscessus, and 27 were Mycobacterium massiliense. Amikacin, moxifloxacin, linezolid, clofazimine, and tigecycline were active against most isolates and cefoxitin and ciprofloxacin against moderate number of isolates. M. massiliense remained susceptible to macrolides; in contrast, M. abscessus became highly resistant on day 14 after incubation. DST pattern did not differ between clarithromycin and azithromycin. IR to clarithromycin was correlated with erm(41) genotype in M. abscessus. Variations in susceptibility to antimicrobial agents within species and the difference in DST patterns between M. abscessus and M. massiliense suggest that DST and identification of M. abscessus complex are significant before treatment.

摘要

我们针对包括新候选药物在内的多种抗菌药物进行了药敏试验(DST),并研究了脓肿分枝杆菌复合群中对大环内酯类药物的诱导性耐药(IR)与erm(41)基因之间的关系。对来自韩国2家三级护理医院的62株脓肿分枝杆菌复合群菌株进行了10种抗菌药物的检测。其中35株为脓肿分枝杆菌,27株为马赛分枝杆菌。阿米卡星、莫西沙星、利奈唑胺、氯法齐明和替加环素对大多数菌株有活性,头孢西丁和环丙沙星对中等数量的菌株有活性。马赛分枝杆菌对大环内酯类药物仍敏感;相比之下,脓肿分枝杆菌在培养14天后出现高度耐药。克拉霉素和阿奇霉素的DST模式没有差异。脓肿分枝杆菌中对克拉霉素的IR与erm(41)基因型相关。种内对抗菌药物敏感性的差异以及脓肿分枝杆菌和马赛分枝杆菌之间DST模式的不同表明,在治疗前进行脓肿分枝杆菌复合群的DST和鉴定具有重要意义。

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