Ho Y I, Chan C Y, Cheng A F
Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT.
J Antimicrob Chemother. 1997 Jul;40(1):27-32. doi: 10.1093/jac/40.1.27.
Aminoglycoside-aminocyclitols including streptomycin, kanamycin, capreomycin and amikacin showed considerable activity against Mycobacterium tuberculosis, with MICs well below their Cmax and relatively low MBC/MIC ratios. Kanamycin, capreomycin and amikacin remained highly active against 'resistant' and 'multidrug-resistant' M. tuberculosis isolates except for some 'multidrug-resistant' isolates which showed complete cross-resistance between streptomycin and the selected 2-deoxystreptamines. Gentamicin displayed anti-tuberculous activity but was bacteriostatic only. Non-tuberculosis mycobacteria, in particular Mycobacterium chelonae and Mycobacterium avium-intracellulare, were more resistant than M. tuberculosis. Amikacin was inhibitory against Mycobacterium kanasii, Mycobacterium scrofulaceum and Mycobacterium fortuitum, but was bactericidal against M. scrofulaceum only. Kanamycin was also bactericidal against M. scrofulaceum. Growth of M. fortuitum was inhibited by amikacin and neomycin which was also inhibitory against M. tuberculosis and M. scrofulaceum. Although the application of neomycin has been limited by its high toxicity, this study suggested that this drug might be useful as a topical agent for cutaneous infections by M. fortuitum.
包括链霉素、卡那霉素、卷曲霉素和阿米卡星在内的氨基糖苷类氨基环醇类药物对结核分枝杆菌显示出相当强的活性，其最低抑菌浓度（MIC）远低于其血药浓度峰值（Cmax），且最低杀菌浓度与最低抑菌浓度之比（MBC/MIC）相对较低。卡那霉素、卷曲霉素和阿米卡星对“耐药”和“耐多药”结核分枝杆菌分离株仍保持高度活性，但某些“耐多药”分离株除外，这些分离株在链霉素和所选的2-脱氧链霉胺之间表现出完全交叉耐药。庆大霉素显示出抗结核活性，但仅具有抑菌作用。非结核分枝杆菌，尤其是龟分枝杆菌和鸟分枝杆菌复合群，比结核分枝杆菌更具耐药性。阿米卡星对堪萨斯分枝杆菌、瘰疬分枝杆菌和偶然分枝杆菌有抑制作用，但仅对瘰疬分枝杆菌有杀菌作用。卡那霉素对瘰疬分枝杆菌也有杀菌作用。阿米卡星和新霉素可抑制偶然分枝杆菌的生长，新霉素对结核分枝杆菌和瘰疬分枝杆菌也有抑制作用。尽管新霉素因其高毒性而应用受限，但本研究表明该药物可能作为治疗偶然分枝杆菌皮肤感染的外用药物。
