夫西地酸对分枝杆菌的体外抑菌效果评价  

Evaluation of in vitro activity of fusidic acid against mycobacteria

作　　者：程梦丽 姜广路[1] 霍凤敏[1] 薛毅 于霞[1] Cheng Mengli;Jiang Guanglu;Huo Fengmin;Xue Yi;Yu Xia(National Clinical Laboratory on Tuberculosis,Beijing Key Laboratory for Drug-Resistant Tuberculosis Research,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Institute,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院、北京市结核病胸部肿瘤研究所、国家结核病临床实验室、耐药结核病研究北京市重点实验室,北京101149

出　　处：《中国防痨杂志》2024年第4期461-466,共6页Chinese Journal of Antituberculosis

基　　金：高层次公共卫生技术人才建设项目培养计划(学科骨干-02-49)。

摘　　要：目的:评价夫西地酸(fusidic acid,FA)对分枝杆菌的体外抑菌效果。方法:选取首都医科大学附属北京胸科医院菌株库保存的分枝杆菌标准菌株和临床分离株作为研究菌株,其中,分枝杆菌标准菌株共计45株,包括26株快速生长型分枝杆菌(rapidly growing mycobacteria,RGM)菌株和19株缓慢生长型分枝杆菌(slowly growing mycobacteria,SGM)菌株;分枝杆菌临床分离株共计129株,为首都医科大学附属北京胸科医院2017年1月至2018年12月分离获得,包括结核分枝杆菌(Mycobacterium tuberculosis,MTB)药物敏感株26株、耐多药(multidrug-resistant,MDR)MTB菌株29株、广泛耐药(extensive drug-resistant,XDR)MTB菌株30株、鸟分枝杆菌分离株23株和戈登分枝杆菌分离株21株。采用肉汤稀释法药物敏感性试验,测定FA对研究菌株的最低抑菌浓度(minimum inhibitory concentration,MIC)、MIC_(50)、MIC_(90)、MIC_(99),并将MIC≤16μg/ml的菌株定义为FA敏感株,分析菌株对FA的耐药情况。结果:RGM和SGM标准菌株对FA的耐药率分别为23.1%(6/26)和21.1%(4/19)。FA对MDR-MTB临床分离株的MIC_(50)、MIC_(90)、MIC_(99)分别是4、16、16μg/ml,MTB临床分离株对FA的耐药率为3.5%(3/85),其中MTB药物敏感株、MDR-MTB和XDR-MTB菌株的耐药率分别为0、0和10.0%(3/30)。鸟分枝杆菌和戈登分枝杆菌临床分离株对FA的耐药率分别为17.4%(4/23)和9.5%(2/21)。FA对分枝杆菌临床分离株的MIC_(50)、MIC_(90)、MIC_(99)值分别为4、16、>32μg/ml,分枝杆菌临床分离株对FA的总体耐药率为7.0%(9/129)。结论:FA对分枝杆菌菌种具有较强的抑菌活性,其中对MTB临床分离株具有很好的抑菌效果。Objective:To evaluate the in vitro inhibitory activity of fusidic acid(FA)against mycobacteria.Methods:The standard strains and clinical isolates of mycobacteria stored in the strain bank of Beijing Chest Hospital,Capital Medical University were selected as the research strains.There were 45 standard strains of mycobacteria,including 26 rapidly growing mycobacteria(RGM)strains and 19 slowly growing mycobacteria(SGM)strains.A total of 129 clinical isolates of mycobacteria were isolated from Beijing Chest Hospital,Capital Medical University from January 2017 to December 2018,including 26 Mycobacterium tuberculosis(MTB)sensitive strains,29 multidrug-resistant(MDR)strains,30 extensive drug-resistant(XDR)strains,23 Mycobacterium avium strains and 21 Mycobacterium gordon strains.Broth microdilution method was used to test the minimal inhibitory concentrations(MIC),MIC_(50),MIC_(90) and MIC_(99) of mycobacteria strains against FA,and the strains with MIC≤16μg/ml were defined as FA sensitive strains.The drug resistance of the strains to FA was analyzed.Results:The resistance rates of RGM and SGM standard strains to FA were 23.1%(6/26)and 21.1%(4/19),respectively.The MIC_(50),MIC_(90),and MIC_(99) values of FA for MDR-MTB clinical isolates were 4,16,and 16μg/ml,respectively.The resistance rate of MTB clinical isolates to FA was 3.5%(3/85),with the resistance rates of MTB drug sensitive strains,MDR-MTB,and XDR-MTB strains being 0,0,and 10.0%(3/30),respectively.The resistance rates of clinical isolates of Mycobacterium avium and Mycobacterium gordon to FA were 17.4%(4/23)and 9.5%(2/21),respectively.The MIC_(50),MIC_(90),and MIC_(99) values of FA for clinical isolates of mycobacterium were 4,16,and>32μg/ml,respectively.The overall resistance rate of FA for clinical isolates of mycobacterium was 7.0%(9/129).Conclusion:FA has high antibacterial activity against mycobacterium species and has a good antibacterial effect on MTB clinical isolates.

关 键 词：分枝杆菌属 微生物敏感性试验 抗菌药 体外研究 夫西地酸 

分 类 号：R378.91[医药卫生—病原生物学] R917[医药卫生—基础医学]