5种中国罕见慢速生长非结核分枝杆菌标准株及临床分离株的药物敏感性分析

肖士林 赵秀芹 刘志广 刘海灿 李马超 蒋毅 赵丽丽 李桂莲 万康林

引用本文: 肖士林, 赵秀芹, 刘志广, 刘海灿, 李马超, 蒋毅, 赵丽丽, 李桂莲, 万康林. 5种中国罕见慢速生长非结核分枝杆菌标准株及临床分离株的药物敏感性分析[J]. 疾病监测. DOI: 10.3784/j.issn.1003-9961.2020.05.015 shu
Citation:  Shilin Xiao, Xiuqin Zhao, Zhiguang Liu, Haican Liu, Machao Li, Yi Jiang, Lili Zhao, Guilian Li and Kanglin Wan. Antibiotic susceptibility of reference and clinical strains of slowly growing non-tuberculosis Mycobacteria of 5 species rarely isolated in China[J]. Disease Surveillance. DOI: 10.3784/j.issn.1003-9961.2020.05.015 shu

5种中国罕见慢速生长非结核分枝杆菌标准株及临床分离株的药物敏感性分析

    作者简介: 肖士林,男,北京市人,本科,主管技师,主要从事微生物检测工作,Email:xiaoshilin@icdc.cn;
    通信作者: 李桂莲, liguilian@icdc.cn 万康林, wankanglin@icdc.cn
  • 基金项目: 国家科技重大专项(No.2018ZX10101002,2018ZX10103001-003-012)

摘要: 目的分别对熊本、慢生黄、施氏、苏尔加、三重分枝杆菌5种中国罕见分离的慢速生长非结核分枝杆菌标准株和临床分离株的药物敏感性进行分析。方法用微孔板Alamar blue显色法分别检测1株熊本分枝杆菌、3株慢生黄分枝杆菌、2株施氏分枝杆菌、2株苏尔加分枝杆菌、2株三重分枝杆菌等临床分离株及相应标准株对利福平、克拉霉素和阿米卡星等36种药物的最小抑菌浓度,判断分析其敏感性,并比较标准株及相应临床分离株对36种药物的敏感性差异。结果5种非结核分枝杆菌菌株中,多数对利福霉素类的利福喷丁和利福布丁、氨基糖苷类、多数氟喹诺酮类、卷曲霉素、大环内酯类(克拉霉素、罗红霉素和阿奇霉素)、利奈唑胺和氯法齐明等敏感。 三重分枝杆菌还对头孢菌素类药物表现出一定的敏感性。结论熊本、慢生黄、施氏、苏尔加、三重分枝杆菌等对克拉霉素等多种药物敏感,但有的临床分离株表现为耐药,治疗这些菌种感染时最好进行药物敏感性试验并联合用药。

English

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  • 表 1  36种药物的配制方法、储存液浓度及浓度检测范围

    Table 1.  Solvents,stock solution concentrations and concentration test ranges of 36 antibiotics

    药物种类药物溶剂储存液浓度(mg/ml)浓度检测范围(μg/ml)
    利福霉素类利福平二甲基亚砜5.12 64.00~0.03
    利福布丁二甲基亚砜1.28 64.00~0.03
    利福喷丁二甲基亚砜0.64 64.00~0.03
    氨基糖苷类链霉素灭菌水5.12256.00~0.25
    阿米卡星灭菌水1.28 64.00~0.03
    卡那霉素灭菌水1.28 64.00~0.03
    妥布霉素灭菌水1.28 64.00~0.03
    喹诺酮类氧氟沙星1%氢氧化钠1.28 64.00~0.03
    左氧氟沙星1%氢氧化钠1.28 64.00~0.03
    莫西沙星灭菌水1.28 64.00~0.03
    司帕沙星1%氢氧化钠1.28 64.00~0.03
    环丙沙星1%氢氧化钠0.64 64.00~0.03
    加替沙星氯仿5.12128.00~0.13
    大环内酯类克拉霉素二甲基亚砜0.64 64.00~0.03
    阿奇霉素二甲基甲酰胺5.12 64.00~0.03
    罗红霉素二甲基甲酰胺5.12 64.00~0.03
    红霉素甲醇5.12 64.00~0.03
    噁唑烷酮类利奈唑胺二甲基亚砜1.28 64.00~0.03
    四环素类四环素甲醇5.12256.00~0.25
    多西环素灭菌水5.12256.00~0.25
    替加环素灭菌水5.12256.00~0.25
    米诺环素灭菌水0.64 64.00~0.03
    头孢菌素类头孢吡肟灭菌水5.12256.00~0.25
    头孢哌酮灭菌水5.12256.00~0.25
    头孢美唑灭菌水5.12256.00~0.25
    抗结核药异烟肼灭菌水5.12256.00~0.25
    乙胺丁醇灭菌水5.12256.00~0.25
    力克肺蒺二甲基甲酰胺5.12256.00~0.25
    乙硫异烟胺二甲基亚砜5.12256.00~0.25
    环丝氨酸灭菌水5.12256.00~0.25
    抗麻风药氨苯砜甲醇5.12256.00~0.25
    氨硫脲1%氢氧化钠5.12256.00~0.25
    氯法齐明二甲基甲酰胺5.12 64.00~0.03
    多肽类卷曲霉素灭菌水5.12128.00~0.03
    磺胺类磺胺甲恶唑1%氢氧化钠5.12256.00~0.25
    碳青霉烯类美罗培南二甲基亚砜5.12256.00~0.25
    下载: 导出CSV

    表 2  5种慢速生长非结核分枝杆菌对36种药物的最小抑菌浓度(μg/ml)及敏感性

    Table 2.  MICs(μg/ml)of 36 antibiotics to 5 species of nontuberculous mycobacteria and strains’ drug susceptibility patterns

    菌株编号菌种利福霉素类氨基糖苷类喹诺酮类大环内酯类多肽类唑烷酮
    RFPRFBRAP STRAMKKANTBM OFLEFMOXSPACIPGAT CLARAZIROXERY CPM LZD
    1510096熊本分枝杆菌 4.000.130.258.002.004.000.061.000.500.13≤0.030.250.50≤0.038.00≤0.132.008.0016.00
    95095熊本分枝杆菌 16.000.254.004.004.008.004.004.002.001.001.004.000.5016.002.001.001.00
    1506112慢生黄分枝杆菌8.000.132.008.008.004.001.004.002.000.250.500.500.500.5016.001.008.0032.008.00
    1506136慢生黄分枝杆菌4.00≤0.031.004.004.002.000.504.001.000.250.500.500.500.508.000.504.0016.004.00
    1506132慢生黄分枝杆菌8.000.062.004.004.004.000.508.002.000.501.001.000.500.5016.001.004.0016.008.00
    95097慢生黄分枝杆菌2.004.002.008.0016.002.0032.002.001.000.251.001.000.134.000.500.504.00
    1512010施氏分枝杆菌 64.000.258.001.000.501.000.501.000.500.130.500.250.060.500.250.504.001.00
    1512019施氏分枝杆菌 0.500.06≤0.0316.008.004.000.1316.008.001.008.002.000.2516.002.0016.0032.0016.00
    95008施氏分枝杆菌 2.000.062.00≤0.250.130.130.500.250.250.250.060.06≤0.030.130.06≤0.030.50
    1512106苏尔加分枝杆菌≤0.13≤0.030.064.001.002.001.004.002.000.250.501.000.250.064.000.504.0016.000.50
    1512122苏尔加分枝杆菌1.00>64.000.50>256.0016.00>64.0016.008.004.000.501.002.001.004.0064.0032.0032.0016.008.00
    95019苏尔加分枝杆菌≤0.25≤0.03≤0.03≤0.250.130.131.000.500.250.060.060.50≤0.030.13≤0.030.130.13
    1509061三重分枝杆菌 1.00≤0.031.0064.001.002.000.2532.0016.008.000.254.00≤0.03≤0.130.250.13128.001.00
    1506113三重分枝杆菌 ≤0.13≤0.031.0016.002.00>64.008.000.500.250.062.00≤0.138.000.500.250.2564.002.00
    95125三重分枝杆菌 0.500.500.251.000.130.03≤0.250.13≤0.03≤0.03≤0.030.061.00≤0.034.00≤0.030.13
    下载: 导出CSV
    菌株编号菌种四环素类头孢菌素类抗结核药物抗麻风药磺胺类碳青霉烯类
    TETDOXTIGMIN CFPCFTCFZ INHEMBDIPETHCS DAPTACCLF SFT MPM
    1510096熊本分枝杆菌 32.004.00≤0.254.0064.001.0016.00>256.000.254.004.00256.0064.0032.00≤0.1316.0064.00
    95095熊本分枝杆菌 32.000.5016.00128.0032.0032.00>256.00>256.00>256.00256.00>256.00>32.00128.0032.00
    1506112慢生黄分枝杆菌64.0032.00256.0064.00256.00128.00>256.001.0016.002.002.0016.0064.001.00≤0.13128.0064.00
    1506136慢生黄分枝杆菌32.0016.00128.0016.00128.00128.00>256.000.5016.002.000.508.0064.000.50≤0.13>256.0032.00
    1506132慢生黄分枝杆菌64.0032.0032.0032.00128.00128.00>256.001.0032.002.002.008.00128.000.500.25>256.0064.00
    95097慢生黄分枝杆菌8.0064.004.00>256.004.00>256.00>256.00>256.00>256.00128.00>256.0032.00>256.002.00
    1512010施氏分枝杆菌 64.0032.0064.0032.0064.008.0064.008.001.001.001.00128.002.00128.00≤0.138.0064.00
    1512019施氏分枝杆菌 32.0016.0064.0016.00>256.00256.00256.00128.0032.0032.0016.0064.0064.00256.00≤0.13128.0064.00
    95008施氏分枝杆菌 256.001.00>256.004.0016.001.000.500.5064.00>256.000.134.00>256.00
    1512106苏尔加分枝杆菌4.002.002.0016.0016.0064.000.500.501.000.50128.000.5064.00≤0.134.0032.00
    1512122苏尔加分枝杆菌32.00>256.0032.0064.0064.00128.00>256.00>256.002.00>256.00>256.00128.00>256.004.00256.00>256.00
    95019苏尔加分枝杆菌≤0.250.131.002.002.00≤0.25≤0.251.00≤0.25256.00≤0.03≤0.250.50
    1509061三重分枝杆菌 4.000.501.0016.002.004.00>256.00>256.00128.00>256.0064.001.00>256.000.25>256.0032.00
    1506113三重分枝杆菌 32.008.000.258.0064.00>256.00>256.00>256.00>256.00>256.00>256.00128.00>256.002.0032.0016.00
    95125三重分枝杆菌 1.0064.000.06≤0.254.00≤0.25>256.00>256.00256.000.50256.000.130.50≤0.25
      注:RFP. 利福平;RFB. 利福布丁;RAP. 利福喷丁;STR. 链霉素;AMK. 阿米卡星;KAN. 卡那霉素;TBM. 妥布霉素;OF. 氧氟沙星;LEF. 左氧氟沙星;MOX. 莫西沙星;SPA. 司帕沙星;CIP. 环丙沙星;GAT. 加替沙星;CLAR. 克拉霉素;AZI. 阿奇霉素;ROX. 罗红霉素;ERY. 红霉素;CPM. 卷曲霉素;LZD. 利奈唑胺;TET. 四环素;DOX. 多西环素;TIG. 替加环素;MIN. 米诺环素;CFP. 头孢吡肟;CFT. 头孢美唑;CFZ. 头孢哌酮;INH. 异烟肼;EMB. 乙胺丁醇;DIP. 力克肺蒺;ETH. 乙硫异烟胺;CS. 环丝氨酸;DAP. 氨苯砜;TAC. 氨硫脲;CLF. 氯法齐明;SFT. 磺胺甲恶唑;MPM. 美罗培南;−. 未检测菌株对该药物的敏感性;粗体字表示某菌株对该药物耐药,带下划线字表示某菌株对该药物中度敏感
    下载: 导出CSV
  • 2020-0032 5种中国罕见的慢速生长非结核分枝杆菌标准株及临床分离株对36种药物的敏感性分析.docx

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