Philipps J, Radloff P D, Wernsdorfer W, Kremsner P G
Research Unit, Albert Schweitzer Hospital, Lambarene, Gabon.
Am J Trop Med Hyg. 1998 May;58(5):612-8. doi: 10.4269/ajtmh.1998.58.612.
The sensitivity of Plasmodium falciparum to chloroquine, mefloquine, quinine, quinidine, halofantrine, artemisinin, and sulfadoxine/pyrimethamine was investigated in Lambarene, Gabon in 1994. The development of in vitro susceptibility has been traced from 1983 or 1992 to 1994 for chloroquine, mefloquine, halofantrine, and quinine. Standard in vitro microtests according to World Health Organization methodology were performed. Of 33 isolates tested for susceptibility to chloroquine, 31 were resistant, one was borderline, and one isolate was sensitive (mean 50% effective concentration [EC50] = 1.38 micromol/L of blood). With mefloquine, all isolates were fully inhibited below the threshold of resistance (mean EC50 = 0.51 micrmol/L of blood). Of 32 isolates tested with quinine, six had borderline resistance (mean EC50 = 0.54 micromol/L of blood medium mixture). Susceptibility to quinidine was higher with a mean EC50 of 0.15 micromol/L of blood medium mixture. With halofantrine, 26 of 32 isolates matured at 3 nmol/L of blood medium mixture (mean EC50 = 1.64 nmol/L of blood medium mixture), indicating a steep decrease in susceptibility in comparison with 1992. For artemisinin, the mean EC50 was 97.92 nmol/L of blood medium mixture. Sulfadoxine/pyrimethamine showed five of 16 resistant isolates with a mean EC50 of 2.46 nmol/L of blood medium mixture. Whereas chloroquine resistance remained stable with a tendency to decrease, susceptibility to mefloquine and quinine was slightly decreased. A significant increase in the mean EC50 and EC90 in comparison with our previous data from Gabon was found for halofantrine.
1994年在加蓬的兰巴雷内对恶性疟原虫对氯喹、甲氟喹、奎宁、奎尼丁、卤泛群、青蒿素和周效磺胺/乙胺嘧啶的敏感性进行了研究。从1983年或1992年至1994年追踪了氯喹、甲氟喹、卤泛群和奎宁体外敏感性的发展情况。按照世界卫生组织的方法进行了标准的体外微量试验。在检测氯喹敏感性的33株分离株中，31株耐药，1株临界，1株敏感（平均50%有效浓度[EC50]=1.38微摩尔/升血液）。对于甲氟喹，所有分离株在耐药阈值以下均被完全抑制（平均EC50=0.51微摩尔/升血液）。在用奎宁检测的32株分离株中，6株有临界耐药（平均EC50=0.54微摩尔/升血液培养基混合物）。对奎尼丁的敏感性较高，平均EC50为0.15微摩尔/升血液培养基混合物。对于卤泛群，32株分离株中有26株在3纳摩尔/升血液培养基混合物中成熟（平均EC50=1.64纳摩尔/升血液培养基混合物），表明与1992年相比敏感性急剧下降。对于青蒿素，平均EC50为97.92纳摩尔/升血液培养基混合物。周效磺胺/乙胺嘧啶在16株耐药分离株中有5株，平均EC50为2.46纳摩尔/升血液培养基混合物。氯喹耐药性保持稳定并有下降趋势，而对甲氟喹和奎宁的敏感性略有下降。与我们之前来自加蓬的数据相比，卤泛群的平均EC50和EC90显著增加。
