Prabhakaran K, Harris E B, Randhawa B
GWL Hansen's Disease Center, Louisiana State University, US Public Health Service, Baton Rouge 70894-2059, USA.
Microbios. 1997;91(366):7-14.
Drug-resistant tuberculosis and opportunistic infections by mycobacteria in immunocompromised subjects are not readily controlled with the antimycobacterial drugs now available. beta-Lactam antibiotics, the most widely used antibacterial agents, are ineffective against mycobacteria since they synthesize beta-lactamases. The beta-lactam/beta-lactamase-inhibitor combinations are used at present to treat infections caused by other beta-lactamase-positive organisms. Six potentially-pathogenic mycobacteria: Mycobacterium avium, M. chelonei, M. haemophilum, M. microti, M. scrofulaceum and M. simiae, were cultured in 7H9 medium (containing Tween 80 and albumin, dextrose, catalase) at 37 degrees C for 10-14 days, with or without various concentrations (2-100 micrograms/ml) of ampicillin/sulbactam, amoxicillin/clavulanate and piperacillin/tazobactam. More than 50-80% inhibition of the mycobacterial growth was observed at drug levels of 40-100 micrograms/ml in the medium; the drugs were active even when the detergent (Tween 80) was omitted. Against four of the mycobacteria, ampicillin/sulbactam proved to be the most active. The beta-lactam/beta-lactamase-inhibitor combinations may be of use as rational therapeutic agents against mycobacterial infections.
耐药结核病以及免疫功能低下者中分枝杆菌引起的机会性感染，目前现有的抗分枝杆菌药物难以有效控制。β-内酰胺类抗生素是使用最广泛的抗菌药物，由于分枝杆菌能合成β-内酰胺酶，所以对其无效。β-内酰胺/β-内酰胺酶抑制剂联合制剂目前用于治疗由其他β-内酰胺酶阳性菌引起的感染。六种潜在致病性分枝杆菌：鸟分枝杆菌、龟分枝杆菌、嗜血性分枝杆菌、田鼠分枝杆菌、瘰疬分枝杆菌和猿分枝杆菌，在含有吐温80、白蛋白、葡萄糖、过氧化氢酶的7H9培养基中于37℃培养10 - 14天，添加或不添加不同浓度（2 - 100微克/毫升）的氨苄西林/舒巴坦、阿莫西林/克拉维酸和哌拉西林/他唑巴坦。在培养基中药物浓度为40 - 100微克/毫升时，观察到分枝杆菌生长受到50 - 80%以上的抑制；即使省略去污剂（吐温80），这些药物仍有活性。对四种分枝杆菌而言，氨苄西林/舒巴坦的活性最强。β-内酰胺/β-内酰胺酶抑制剂联合制剂可能用作抗分枝杆菌感染的合理治疗药物。
