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中国非结核分枝杆菌的体外药敏试验。

In vitro susceptibility of nontuberculous mycobacteria in China.

机构信息

Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Tuberculosis & Thoracic Tumor Research Institute, Capital Medical University, Beijing, China.

Department of Clinical Laboratory, Guangzhou Chest Hospital, Guangzhou, China.

出版信息

BMC Infect Dis. 2024 Jan 23;24(1):118. doi: 10.1186/s12879-024-09016-6.

Abstract

OBJECTIVES

This study aimed to measure the prevalence of resistance to antimicrobial agents, and explore the risk factors associated with drug resistance by using nontuberculous Mycobacteria (NTM) isolates from China.

METHODS

A total of 335 NTM isolates were included in our analysis. Broth dilution method was used to determine in vitro drug susceptibility of NTM isolates.

RESULTS

Clarithromycin (CLA) was the most potent drug for Mycobacterium intracellulare (MI). The resistance rate of 244 MI isolates to CLA was 21%, yielding a minimum inhibitory concentrations (MIC) and MIC of 8 and 64 mg/L, respectively. 51% of 244 MI isolates exhibited resistance to amikacin (AMK). For 91 Mycobacterium abscessus complex (MABC) isolates, 6 (7%) and 49 (54%) isolates were categorized as resistant to CLA at day 3 and 14, respectively. The resistance rate to CLA for Mycobacterium abscessus subspecies abscessus (MAA) was dramatically higher than that for Mycobacterium abscessus subspecies massiliense (MAM). Additionally, the percentage of patients presenting fever in the CLA-susceptible group was significantly higher than that in the CLA-resistant group.

CONCLUSIONS

Our data demonstrate that approximate one fifth of MI isolates are resistant to CLA. We have identified a higher proportion of CLA-resistant MAA isolates than MAM. The patients caused by CLA-resistant MI are at low risk for presenting with fever relative to CLA-susceptible group.

摘要

目的

本研究旨在通过中国非结核分枝杆菌(NTM)分离株,测量抗微生物药物耐药率,并探讨与耐药相关的危险因素。

方法

共纳入 335 株 NTM 分离株进行分析。采用肉汤稀释法检测 NTM 分离株的体外药物敏感性。

结果

克拉霉素(CLA)对细胞内分枝杆菌(MI)的活性最强。244 株 MI 分离株对 CLA 的耐药率为 21%,最低抑菌浓度(MIC)和 MIC90 值分别为 8 和 64mg/L。244 株 MI 分离株中有 51%对阿米卡星(AMK)耐药。91 株脓肿分枝杆菌复合体(MABC)分离株中,CLA 在第 3 天和第 14 天分别有 6(7%)和 49(54%)株被归类为耐药。脓肿分枝杆菌亚种脓肿(MAA)对 CLA 的耐药率明显高于脓肿分枝杆菌亚种马萨诸塞(MAM)。此外,CLA 敏感组发热患者的比例明显高于 CLA 耐药组。

结论

我们的数据表明,大约五分之一的 MI 分离株对 CLA 耐药。我们发现 CLA 耐药 MAA 分离株的比例高于 MAM。与 CLA 敏感组相比,由 CLA 耐药 MI 引起的患者发热的风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b56/10804778/deddfe93198a/12879_2024_9016_Fig1_HTML.jpg

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