Department of Infectious Diseases, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, The Second Affiliated Hospital of Shanghai University, Wenzhou, People's Republic of China.
Laboratory of Infectious Diseases, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, The Second Affiliated Hospital of Shanghai University, Wenzhou, People's Republic of China.
Ann Med. 2022 Dec;54(1):2500-2510. doi: 10.1080/07853890.2022.2121984.
To determine the minimum inhibitory concentration (MIC) distribution of antibacterial drugs and the susceptibility of non-tuberculous mycobacterial (NTM) isolates to provide a reference basis for the clinical selection of an effective starting regimen. The common clinical isolates of NTM in the respiratory tract, which met the standards of the American Thoracic Society for NTM lung disease, were collected. The MICs of 81 isolates were determined using the microbroth dilution method (Thermo Fisher Scientific, USA), as recommended by the Clinical and Laboratory Standards Institute, USA. Included were 43 complex (MAC) strains, 24 complex (MAB) strains, and 14 strains. The sensitivity rates of MAC to clarithromycin and amikacin were 81.4% and 79.1%, respectively, while the sensitivity rates to linezolid and moxifloxacin were only 20.9% and 9.3%; the MIC of rifabutin was the lowest (MIC50% was just 2 μg/mL). After incubation for 3-5 days, the sensitivity rate of MAB to clarithromycin was 87.5%; this decreased to 50% after 14 days' incubation. Most of them were susceptible to amikacin (91.6%), and most were resistant to moxifloxacin (95.8%), ciprofloxacin (95.8%), imipenem (95.8%), amoxicillin/clavulanate (95.8%), tobramycin (79.1%), doxycycline (95.8%) and trimethoprim/sulfamethoxazole (95.8%). intermediate (83.3%) and resistant (16.7%) to cefoxitin. The susceptibility to linezolid was only 33.3%. The sensitivity and resistance breakpoints of tigecycline were set to ≤0.5 and ≥8 μg/mL, respectively, and the sensitivity and resistance rates were 50% and 0%, respectively. was susceptible to clarithromycin, amikacin, linezolid, moxifloxacin, rifampicin and rifabutin (100%). In Wenzhou, clarithromycin, amikacin and rifabutin have good antibacterial activity against MAC, while linezolid and moxifloxacin have high resistance. Amikacin and tigecycline have strong antibacterial activity against MAB, while most other antibacterial drugs are resistant to varying degrees. Most antibacterial drugs are susceptible to . and have good antibacterial activity. The identification of NTM species and the detection of their MICs have certain guiding values for the treatment of NTM lung disease.Key MessageThe three most common respiratory non-tuberculous mycobacterial (NTM) isolates with clinical significance in the Wenzhou area were tested for drug susceptibility. The broth microdilution method was used to determine the minimum inhibitory concentration distribution of antibacterial drugs and the susceptibility of NTM isolates to provide a reference basis for the clinical selection of an effective starting regimen.
为了确定抗菌药物的最低抑菌浓度(MIC)分布和非结核分枝杆菌(NTM)分离株的药敏性,为临床选择有效的起始治疗方案提供参考依据。收集符合美国胸科学会(ATS)NTM 肺部疾病标准的呼吸道常见临床分离株 NTM。采用微量肉汤稀释法(美国热电 Fisher 科学公司),按照美国临床和实验室标准化协会的建议,对 81 株分离株的 MIC 进行测定。包括 43 株复合(MAC)株、24 株复合(MAB)株和 14 株。MAC 对克拉霉素和阿米卡星的敏感率分别为 81.4%和 79.1%,而利奈唑胺和莫西沙星的敏感率仅为 20.9%和 9.3%;利福平的 MIC 最低(MIC50%仅为 2μg/ml)。孵育 3-5 天后,MAB 对克拉霉素的敏感率为 87.5%;孵育 14 天后,这一比例降至 50%。它们大多对阿米卡星(91.6%)敏感,对莫西沙星(95.8%)、环丙沙星(95.8%)、亚胺培南(95.8%)、阿莫西林克拉维酸(95.8%)、妥布霉素(79.1%)、多西环素(95.8%)和磺胺甲恶唑(95.8%)的耐药率较高。头孢西丁中介(83.3%)和耐药(16.7%)。利奈唑胺的敏感性仅为 33.3%。替加环素的药敏和耐药折点分别设定为≤0.5 和≥8μg/ml,药敏率和耐药率分别为 50%和 0%。对克拉霉素、阿米卡星、利奈唑胺、莫西沙星、利福平利福布汀(100%)敏感。在温州,克拉霉素、阿米卡星和利福平对 MAC 具有良好的抗菌活性,而利奈唑胺和莫西沙星的耐药率较高。阿米卡星和替加环素对 MAB 具有较强的抗菌活性,而其他大多数抗菌药物均有不同程度的耐药性。大多数抗菌药物对均敏感,具有良好的抗菌活性。鉴定 NTM 种属并检测其 MIC 对 NTM 肺部疾病的治疗具有一定的指导价值。
关键信息
对温州地区三种最常见的具有临床意义的呼吸道非结核分枝杆菌(NTM)分离株进行药敏试验。采用微量肉汤稀释法测定抗菌药物的最低抑菌浓度分布和 NTM 分离株的药敏性,为临床选择有效的起始治疗方案提供参考依据。