耐多药结核分枝杆菌对第5组抗结核药物的耐药性分析

Drug resistance to group 5 anti-tuberculosis agents in multi-drug resistant Mycobacterium tuberculosis

关键词:  结核  肺  抗多种药物性  结核分枝杆菌  第5组抗结核药物  药物耐受性

Key words:  tuberculosis  pulmonary  multidrug-resistant  mycobacterium tuberculosis  group 5 anti-tuberculosis agents  tolerance

摘要:

目的了解耐多药结核分枝杆菌对第5组抗结核药物的耐药情况。方法选取入组TMC207治疗耐多药结核病（multi-drug resistant tuberculosis，MDR-TB）的全球多中心试验的15例患者，取入组前清晨痰液，遥至比利时安特卫普热带医学中心进行菌种鉴定，同时采用比例法对13种抗结核药物进行敏感试验（drug susceptibility test，DST），包括异烟肼、利福平、乙胺丁醇、链霉素、氧氟沙星、卡那霉素、卷曲霉素、乙硫异烟胺、氯法齐明、利奈唑胺、氨硫脲、阿莫西林／克拉维酸和吡嗪酰胺，并用绝对浓度法对阿米卡星、丙硫异烟胺、对氨基水杨酸钠和左氧氟沙星进行敏感试验。结果15例MDR-TB患者痰结核分枝杆菌对第5组抗结核药物的耐药结果为，氯法齐明耐药率为40．0％（6／15），氨硫脲耐药率为60．0％（9／15），阿莫西林／克拉维酸耐药率为86．7％（13／15），利奈唑胺全敏感。结论部分第5组抗结核药物体外对MDR-TB菌株具有良好的抗菌活性，在条件允许的情况下推荐用于MDR-TB患者的治疗。

Abstract:

Objective To investigate the drug resistance to drug resistant Mycobacterium tuberculosis. Methods The group 5 anti-tuberculosis agents in multi- morning sputum samples were collected from 15 patients, who participated in global multi-center trial of TMC207 for multi-drug resistant tuberculosis （MDR-TB）. The bacterial strains were identified in the Institute of Tropical Medicine in Antwerp, Belgian and drug-resistance to 13 anti-tuberculosis agents were performed, including isoniazid, fifampicin, ethambutol, streptomycin, ofloxacin, kanamycin, capreomycin, ethionamide, clofazimine, linezolid, thiacetazone, augmentin and pyrazinamide. The drug susceptiveness to amikacin, protionamide, para-aminosalicylate and levofloxacin were tested with L-J proportion method. Results The rates of drug resistance to group 5 anti-tuberculosis agents in 15 samples were： 40.0% （6/15） to clofazimine, 60.0% （9/15） to thiacetazone, 86. 7% （ 13/15 ） to augmentin and 100.0% to linezolid （15/15）. Conclusion The results indicate that group 5 anti-tuberculosis agents can be recommended for the treatment of MDR-TB.