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[麻风分枝杆菌对氨苯砜和利福平的耐药性:关于在佛得角地区(塞内加尔)开展的一项调查]

[Resistance of Mycobacterium leprae to dapsone and rifampicin: apropos of a survey carried out in the Cape Verde region (Senegal)].

作者信息

Grosset J, Guelpa-Lauras C C, Millan J, Bodian M, Perani E

出版信息

Med Trop (Mars). 1987 Apr-Jun;47(2):171-5.

PMID:3306248
Abstract

Since 1983, primary resistance of M. leprae to DDS and rifampicin has been evaluated in new cases of lepromatous leprosy observed in the Cap-Verde region in Senegal. Out of the 13 strains isolated, 10 (77%) have been found resistant to DDS, 7 at low level, 2 at intermediate level, 1 at high level; all of them have been found sensible to rifampicin. Similar results have been obtained with 57 strains isolated from patients not yet treated coming from different geographical areas, seeing that 37, i.e. 65%, were resistant to DDS, 27 at low level, 5 at intermediate level and 5 at high level; all of them were sensible to rifampicin. Level of resistance to DDS is very different in case of acquired resistance. In 69 lepromatous patients treated for more than 5 years and showing a relapse, M. leprae was 62 times, i.e. 90%, resistant to DDS, 6 times at low level, 21 at intermediate level and 35 at high level; in addition, 13 times M. leprae was resistant to rifampicin. In order to avoid and to solve problems set by resistance of M. leprae to antibiotics, strict application of polychemotherapy of leprosy is compulsory.

摘要

自1983年以来,在塞内加尔佛得角地区观察到的瘤型麻风新病例中,对麻风分枝杆菌对氨苯砜和利福平的原发性耐药性进行了评估。在分离出的13株菌株中,发现10株(77%)对氨苯砜耐药,7株为低水平耐药,2株为中等水平耐药,1株为高水平耐药;所有菌株对利福平均敏感。从来自不同地理区域的未经治疗的患者中分离出的57株菌株也得到了类似结果,其中37株(即65%)对氨苯砜耐药,27株为低水平耐药,5株为中等水平耐药,5株为高水平耐药;所有菌株对利福平均敏感。获得性耐药情况下对氨苯砜的耐药水平差异很大。在69例接受治疗超过5年且复发的瘤型麻风患者中,麻风分枝杆菌对氨苯砜的耐药率为62倍(即90%),6次为低水平耐药,21次为中等水平耐药,35次为高水平耐药;此外,麻风分枝杆菌对利福平耐药13次。为了避免和解决麻风分枝杆菌对抗生素耐药所带来的问题,严格应用麻风联合化疗是必不可少的。

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