阿奇霉素对泌尿生殖道沙眼衣原体临床株的单独和联合药物敏感性检测  

In vitro susceptibilities of urogenital Chlamydia trachomatis clinical isolates to azithromycin alone and in combination with other antimicrobial agents

作　　者：王梅[1] 江勇[2] 邵丽丽[1] 刘原君[1] 侯淑萍[1] 刘全忠[1] 

机构地区：[1]天津医科大学总医院皮肤科/天津性传播疾病研究所,300052 [2]天津医科大学附属第二医院皮肤科

出　　处：《中华微生物学和免疫学杂志》2010年第8期722-726,共5页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金项目（30872285）

摘　　要：目的 检测本地区近年来泌尿生殖道沙眼衣原体临床分离株对阿奇霉素的药物敏感性,筛查耐药株,以及体外阿奇霉素与莫西沙星、多西环素、米诺环素和利福平的相互作用情况.方法 将经McCoy细胞培养法检测出的41例沙眼衣原体临床株,传代培养至感染率达90%以上,收集标本进行阿奇霉素、莫西沙星、多西环素、米诺环素和利福平5种抗菌药物的药敏试验,采用棋盘稀释法测定阿奇霉素与莫西沙星、阿奇霉素与多西环素、阿奇霉素与米诺环素、阿奇霉素与利福平4组抗菌药物联合后的体外相互作用情况.结果 阿奇霉素最低抑菌浓度（MIC）结果为0.063～0.5μg/ml.阿奇霉素与莫西沙星、多西环素和利福平体外联合时对分别对51.22%、53.66%和58.54%的菌株为协同或相加作用,统计结果显示3组之间差异无统计学意义（P＞0.05） 阿奇霉素与米诺环素联合时对90.24%的菌株为拮抗作用.结论 在体外,阿奇霉素与莫西沙星、多西环素或利福平联用,能够提高各自的抗菌活性,可能对治疗沙眼衣原体反复感染或持续感染患者的疗效优于单用一种抗菌药物 相反,阿奇霉素与米诺环素联合应用时,它们之间的拮抗作用将极大地降低各自的抗菌活性.联合药敏试验在一定程度上能够弥补单独药敏实验的一些不足.Objective To test the in vitro activity of azithromycin against recent clinical isolates of urogenital Chlamydia trachomatis, and combined activity of azithromycin with moxifloxacin, rifampicin, doxycycline and minocyline. Methods When more than 90% McCoy cells were infected, the 41 strains tested were collected to investigate minimal inhibitory concentrations （MICs） of 5 antimicrobials alone. Checkerboard array was used to calculate the fractional inhibitory concentrations（FICs） and then detected the interactions among the various combinations. Results In vitro, synergism or additivity effect of 51.22%,53.66% and 58.54% strains was found in azithromycin-moxifloxacin, azithromycin-doxycycline and asithromycin-rifampicin combinations, respectively. No difference was observed in all of the combinations （ P 〉0.05）. However, antagonism effect of 90.24% strains was observed in azithromycin-minocyline combination. Conclusion This study indicates that the combination of azithromycin with moxifloxacin, doxycycline or rifampicin is more effective against Chlamydia trachomatis than individual antimicrobials. Therefore, these antimicrobials combinations might be recommended against Chlamydia trachomatis recurrent or persisitent infection. However, the combination of azithromycin with minocyline exhibited a markedly antagonism activity against Chlamydia trachomatis. Combined sensitivity test to a certain extent can compensate for some shortcomings of individual susceptibility test.

关 键 词：沙眼衣原体 阿奇霉素 最低抑菌浓度 部分抑菌浓度 药物相互作用 

分 类 号：R446.5[医药卫生—诊断学]