耐氧氟沙星结核分枝杆菌对五种氟喹诺酮类药物交叉耐药的研究  

Study on the cross-resistance among 5 different fluroquinolones in ofloxacin-resistant Mycobacterium tuberculosis isolates

作　　者：王前[1] 宋媛媛[1] 逄宇[1] 王玉峰[1] 欧阳琴 赵雁林[1] 

机构地区：[1]中国疾病预防控制中心结核病预防控制中心,北京102206 [2]四川省都江堰市疾病预防控制中心慢性病防治科

出　　处：《中国防痨杂志》2014年第6期453-457,共5页Chinese Journal of Antituberculosis

摘　　要：目的 研究耐氧氟沙星结核分枝杆菌对5种不同氟喹诺酮类药物之间的交叉耐药性.方法 本研究选取来自于2007年全国结核病耐药性基线调查的130株对氧氟沙星耐药的结核分枝杆菌菌株,用微孔板稀释法检测这些菌株对5种氟喹诺酮类药物（氧氟沙星、左氧氟沙星、莫西沙星、加替沙星以及司帕沙星）的最低抑菌浓度,统计耐药率的差别并分析对某种氟喹诺酮类药物耐药的菌株中对其他4种药物的耐药率的差别,组间差异的比较采用卡方检验,以P＜0.05为差异有统计学意义.结果 130株对氧氟沙星耐药的菌株中,分别有110株（84.6％,110/130）、108株（83.1％,108/130）、46株（35.4％,46/130）及66株（50.8％,66/130）对左氧氟沙星、莫西沙星、加替沙星及司帕沙星耐药.加替沙星耐药率显著低于左氧氟沙星（x2=65.641,P＜0.01）、莫西沙星（x2=61.225,P＜0.01）和司帕沙星（x2=6.274,P=0.02）的耐药率.左氧氟沙星耐药菌株中分别有90.9％（100/110）、41.8％（46/110）和59.1％（65/110）的菌株对莫西沙星、加替沙星和司帕沙星耐药;在加替沙星和司帕沙星耐药菌株中,有97.8％（45/46）和97.0％（64/66）对莫西沙星耐药.莫西沙星耐药株中分别有41.7％（45/108）和59.3％（64/108）对加替沙星和司帕沙星耐药.结论 上述5种氟喹诺酮类药物之间呈现出不同的交叉耐药性,其中左氧氟沙星和莫西沙星交叉耐药,加替沙星和司帕沙星与莫西沙星之间表现为部分单向交叉耐药.Objective To investigate the cross resistance among the different fluroquinolones （FQs） in ofloxacin resistant Mycobacterium tuberculosis （M.tuberculosis） isolates.Methods One hundred and thirty ofloxacinresistant M.tuberculosis isolates were selected from national tuberculosis drug-resistant survey conducted in 2007.Broth dilution method was used to detect the minimal inhibitory concentration （MIC） of M.tuberculosis against five FQs,including ofloxacin （Ofx）,levofloxacin （Lfx）,moxifloxacin （Mfx）,gatifloxacin （Gfx） and sparfloxacin （Sfx）.Chi square test was performed to compared the drug resistant rates of different FQs.The difference was considered as significant when P＜0.05.Results Of 130 Ofx-resistant M.tuberculosis isolates,there were 110 （84.6％,110/130）,108 （83.1％,108/130）,46 （35.4％,46/130） and 66 （50.8％,66/130） isolates resistant to Lfx,Mfx,Gfx and Sfx,respectively.Statistical analysis revealed that the Gfx-resistant rate of M.tuberculosis isolates was significantly lower than those of Lfx（x2 =65.641,P＜0.01）,Mfx（x2=61.225,P＜0.01） and Sfx （x2 =6.274,P=0.02）.Among the Lfx-resistant isolates,90.9％（100/110）,41.8％ （46/110） and 59.1％ （65/110） were resistant to Mfx,Gfx and Sfx,respectively.In addition,there were 97.8％ （45/46） and 97.0％ （64/66） of Gfx-and Sfx-resistant isolates resistant to Mfx,respectively.For Gfx-and Sfx-resistant isolates,only 41.7％（45/108） and 59.3％（64/108） showed resistance to Mfx,respectively.Conclusion Our findings demonstrate that the Gfx-and Sfx-resistant rates were significantly lower than those of the others.In addition,the crossresistance is observed between Lfx and Mfx,while there is partially unidirectional cross resistance between Mfx and Gfx/Sfx.

关 键 词：分枝杆菌 结核 荧光喹诺酮类 氧氟沙星 抗药性 细菌 

分 类 号：R978.19[医药卫生—药品]