McClatchy J K, Kanes W, Davidson P T, Moulding T S
Tubercle. 1977 Mar;58(1):29-34. doi: 10.1016/s0041-3879(77)80007-x.
Drug resistant mutants to streptomycin, kanamycin, viomycin, capreomycin, and rifampicin were isolated from four strains of Mycobacterium tuberculosis. The mutants isolated from each parent were then tested for evidence of development of cross-resistance to other drugs. There was no cross-resistance between either streptomycin or rifampicin and any of the other drugs. Complete cross-resistance between viomycin and capreomycin was found. Cross-resistance between kanamycin and capreomycin, and kanamycin and viomycin was variable. A review of the medical histories of 27 patients with kanamycin-resistant tubercle bacilli indicated that cross-resistance with capreomycin and viomycin occurs, but is unpredictable. Because of this variability in cross-resistance and the fact that kanamycin is a more toxic drug than capreomycin, it is suggested that capreomycin be used in the first retreatment regimen for tuberculosis when streptomycin resistance has been demonstrated.
从四株结核分枝杆菌中分离出对链霉素、卡那霉素、紫霉素、卷曲霉素和利福平耐药的突变体。然后对从每个亲本分离出的突变体进行测试，以寻找对其他药物产生交叉耐药性的证据。链霉素或利福平与其他任何药物之间均无交叉耐药性。发现紫霉素和卷曲霉素之间存在完全交叉耐药性。卡那霉素与卷曲霉素之间以及卡那霉素与紫霉素之间的交叉耐药性是可变的。对27例耐卡那霉素结核杆菌患者的病史回顾表明，与卷曲霉素和紫霉素存在交叉耐药性，但无法预测。由于交叉耐药性存在这种变异性，且卡那霉素比卷曲霉素毒性更大，因此建议在已证明对链霉素耐药的情况下，将卷曲霉素用于结核病的首个复治方案。
