Heidarieh Parvin, Mirsaeidi Mehdi, Hashemzadeh Mohamad, Feizabadi Mohamad Mehdi, Bostanabad Saeed Zaker, Nobar Mostafa Ghalami, Hashemi Shahraki Abodolrazagh
1 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences , Alborz, Iran .
2 Division of Pulmonary and Critical Care, Miller School of Medicine, University of Miami, Miami , Florida.
Microb Drug Resist. 2016 Mar;22(2):172-8. doi: 10.1089/mdr.2015.0134. Epub 2015 Oct 15.
Many species of nontuberculous mycobacteria (NTM) have long been identified as important causes of human disease, the incidence of which is rising. Several reports have suggested increasing trend of both in vitro and in vivo resistance to available treatment regimes. The aim of this study was to evaluate antibiotic susceptibility of clinically relevant NTM isolates using standard microbroth dilution test. Antimicrobial susceptibility testing was performed following National Committee for Clinical Laboratory Standards methods for NTM isolates, including 85 Mycobacterium fortuitum, 39 Mycobacterium chelonae, and 30 Mycobacterium abscessus subsp. abscessus as rapidly growing mycobacteria and 48 Mycobacterium simiae and 40 Mycobacterium kansasii as slowly growing mycobacteria. All isolates were recovered from various types of clinical samples and identified by multilocus sequence analysis. Trimethoprim-sulfamethoxazole (TMP-SMZ), amikacin, tobramycin, clarithromycin, moxifloxacin, linezolid, and imipenem showed better activity against M. fortuitum rather than meropenem, ciprofloxacin, cefoxitin, and doxycycline. Amikacin was active against 93% of M. abscessus subsp. abscessus. Linezolid, clarithromycin, cefoxitin, ciprofloxacin, imipenem, moxifloxacin, tobramycin, TMP-SMZ, doxycycline, and meropenem showed some activities on M. abscessus subsp. abscessus as well. The majority of M. abscessus subsp. abscessus and M. chelonae strains were multidrug resistant. Among the 40 isolates of M. kansasii, all were susceptible to ethambutol, isoniazid, clarithromycin, moxifloxacin, and linezolid. These isolates were also resistant to doxycycline and 50% were resistant to rifampicin and ciprofloxacin. M. simiae was resistant to clarithromycin, doxycycline, isoniazid, and TMP-SMZ, and the majority of isolates showed high levels of resistance to linezolid, ethambutol, ciprofloxacin, streptomycin, and rifampicin. The majority of M. simiae isolates were multidrug resistant. Our data confirm the need for performing of standard susceptibility testing of any clinically important NTM isolate.
许多非结核分枝杆菌（NTM）菌种长期以来一直被认为是人类疾病的重要病因，其发病率正在上升。几份报告表明，对现有治疗方案的体外和体内耐药性呈上升趋势。本研究的目的是使用标准微量肉汤稀释试验评估临床相关NTM分离株的抗生素敏感性。按照美国国家临床实验室标准委员会针对NTM分离株的方法进行药敏试验，其中包括85株偶然分枝杆菌、39株龟分枝杆菌和30株脓肿分枝杆菌脓肿亚种作为快速生长分枝杆菌，以及48株猿分枝杆菌和40株堪萨斯分枝杆菌作为缓慢生长分枝杆菌。所有分离株均从各种类型的临床样本中分离得到，并通过多位点序列分析进行鉴定。甲氧苄啶-磺胺甲恶唑（TMP-SMZ）、阿米卡星、妥布霉素、克拉霉素、莫西沙星、利奈唑胺和亚胺培南对偶然分枝杆菌的活性优于美罗培南、环丙沙星、头孢西丁和多西环素。阿米卡星对93%的脓肿分枝杆菌脓肿亚种有活性。利奈唑胺、克拉霉素、头孢西丁、环丙沙星、亚胺培南、莫西沙星、妥布霉素、TMP-SMZ、多西环素和美罗培南对脓肿分枝杆菌脓肿亚种也有一定活性。大多数脓肿分枝杆菌脓肿亚种和龟分枝杆菌菌株对多种药物耐药。在40株堪萨斯分枝杆菌分离株中，所有菌株对乙胺丁醇、异烟肼、克拉霉素、莫西沙星和利奈唑胺敏感。这些分离株对多西环素耐药，50%对利福平耐药，对环丙沙星耐药。猿分枝杆菌对克拉霉素、多西环素、异烟肼和TMP-SMZ耐药，大多数分离株对利奈唑胺、乙胺丁醇、环丙沙星、链霉素和利福平高度耐药。大多数猿分枝杆菌分离株对多种药物耐药。我们的数据证实了对任何临床重要的NTM分离株进行标准药敏试验的必要性。
