耐多药结核分枝杆菌对氟喹诺酮类药物体外交叉耐药及耐药性研究  

Drug Resistance and Cross Resistance of Multi-drug Resistant Mycobacterium Tuberculosis to Fluoroquinolones in vitro

作　　者：任丽娟[1] 黄正谷 王丽[1] 陈雅婷[1] 

机构地区：[1]重庆市公共卫生医疗救治中心,重庆400036

出　　处：《中国药房》2015年第11期1488-1490,共3页China Pharmacy

基　　金：重庆市卫生局医学科研计划项目(No.2008-2-292)

摘　　要：目的:了解结核分枝杆菌对5种抗结核氟喹诺酮类药物之间的交叉耐药性,促进临床合理用药。方法:临床采集耐多药结核(MDR-TB)菌株培养,分别测定5种氟喹诺酮类药物(环丙沙星、氧氟沙星、左氧氟沙星、司帕沙星、莫西沙星)的最低抑菌浓度(MIC)的变化,定性判断是否存在交叉耐药,得出实验室研究数据。结果:各氟喹诺酮类药物对临床分离出异烟肼利福平耐药株耐药率均>70%,耐药率接近,差异无统计学意义(P>0.05);各氟喹诺酮药物之间存在不完全交叉耐药性。结论:临床医师在为患者选择药物治疗方案时,应综合参照药敏试验结果、患者疾病史、用药史等,选择有效的氟喹诺酮类药物治疗MDR-TB。该体外试验可为进一步的体内试验及临床研究氟喹诺酮类药物MDR-TB中的交叉耐药性提供基础。OBJECTIVE： To analyze cross drug resistance of 5 kinds of anti-tuberculosis fluoroquinolones via in vitro experiments. METHODS： The multi-drug resistant mycobacterium tuberculosis （MDR-TB） strain were isolated and cultured in the clinic, and MIC of 5 kinds of fluoroquinolones （ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin and moxifloxacin） were tested for analyzing drug resistance and cross resistance to obtain laboratory data. RESULTS： The resistance rates of isoniazid and rifampin resistant isolates to various fluoroquinolones were all over 70%; drug resistances of them were close to each other; there was no statistical significance （P〉0.05）. There were partial cross resistances among the five fluoroquinolones. CONCLUSIONS： These results could help clinicians choose effective fluoroquinolones for the treatment of MDR-TB by referring to the result of drug sensitivity test, disease history, medication history and so on. The data provides the basis for future in vivo experiments and clinical study of cross resistance of MDR-TB to fluoroquinolone.

关 键 词：结核分枝杆菌 氟喹诺酮类药物 交叉耐药 最低抑菌浓度 

分 类 号：R969.1[医药卫生—药理学] R978.1[医药卫生—药学]