Chang Y T
Int J Lepr Other Mycobact Dis. 1977 Jul-Sep;45(3):235-40.
Ever since the discovery of the foot pad technic for growth of M. leprae in mice, investigators have overemphasized the laboratory results in clinical applications. Overenthusiasm has led to some dire results in the leprosy field. Two well-known examples can be cited, which are based on the presumption that: a) all the nonsolidly stained M. leprae are dead, and b) that a negative finding in the mouse foot pad indicates no growth of M. leprae in the animals. The former led clinical investigators to claim a false emergence of drug resistance after one year's treatment with a potent antileprosy drug, B663, which was almost abandoned for later clinical use. The latter led investigators to introduce a low-dose drug treatment, which resulted in a worldwide appearance of DDS resistance in leprosy. This paper outlines the reasoning that not all nonsolid M. leprae are dead, and that not all the organisms in the foot pads are detectable by the present standard foot pad/ M. leprae technic.
自从发现用足垫技术在小鼠体内培养麻风杆菌以来，研究人员在临床应用中过度强调了实验室结果。过度热情在麻风病领域导致了一些可怕的后果。可以列举两个著名的例子，它们基于这样的假设：a）所有非牢固染色的麻风杆菌都是死的，以及b）小鼠足垫中的阴性结果表明动物体内没有麻风杆菌生长。前者导致临床研究人员在使用强效抗麻风病药物B663治疗一年后声称出现了耐药性假象，该药物后来几乎被放弃用于临床。后者导致研究人员引入低剂量药物治疗，结果在全球范围内出现了麻风病对氨苯砜的耐药性。本文概述了这样的推理，即并非所有非牢固染色的麻风杆菌都是死的，并且并非足垫中的所有微生物都能通过目前标准的足垫/麻风杆菌技术检测到。
