结核分枝杆菌表型药物敏感性试验临界浓度设定发展历程

doi:10.19982/j.issn.1000-6621.20230153

摘要/Abstract

摘要：

结核分枝杆菌表型药物敏感性试验仍是耐药性检测的重要手段,但某些药物结果的准确性和可重复性较差,临界浓度是影响结果的关键因素之一。笔者对结核分枝杆菌表型药物敏感性试验临界浓度的建立及修订过程进行系统总结和介绍,为实验室技术人员和临床医生正确理解药物敏感性试验方法及结果,以及加强更新临界浓度的研究提供借鉴。

关键词: 分枝杆菌,结核, 微生物敏感性试验, 表型, 总结性报告(主题)

Abstract:

Phenotypic drug susceptibility testing of Mycobacterium tuberculosis remains a crucial method for detecting drug resistance. However, the accuracy and reproducibility of certain drugs are sub-optimal with critical concentration being one of the key factors affecting results. This article provides a systematic summary and introduction on establishing and revising critical concentrations for anti-tuberculosis drug susceptibility testing, and offered valuable guidance to laboratory technicians and clinicians for accurately interpreting drug susceptibility testing methods and results, as well as to facilitate critical concentration research.

Key words: Mycobacterium tuberculosis, Microbial sensitivity tests, Phenotype, Consensus development conferences as topic

中图分类号:

宋媛媛, 夏辉, 赵雁林. 结核分枝杆菌表型药物敏感性试验临界浓度设定发展历程[J]. 中国防痨杂志, 2023, 45(7): 631-638. doi: 10.19982/j.issn.1000-6621.20230153

Song Yuanyuan, Xia Hui, Zhao Yanlin. Development process of setting of critical concentrations for phenotypic drug susceptibility testing of Mycobacterium tuberculosis[J]. Chinese Journal of Antituberculosis, 2023, 45(7): 631-638. doi: 10.19982/j.issn.1000-6621.20230153

图/表 1

表1

参考文献 59

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药品	L-J固体比例法(μg/ml)			MGIT液体法(μg/ml)				微孔板法(μg/ml)
	中国推荐¹	WHO 推荐²	CLSI 推荐³	中国推荐¹	WHO 推荐²	CLSI 推荐^3,4	EUCAST 推荐⁵	DST熟练度测试推荐敏感 (≤)⁶	WHO推荐敏感(≤)⁷	CLSI推荐⁴			EUCAST 推荐敏感 (≤)⁵
	中国推荐¹	WHO 推荐²	CLSI 推荐³	中国推荐¹	WHO 推荐²	CLSI 推荐^3,4	EUCAST 推荐⁵	DST熟练度测试推荐敏感 (≤)⁶	WHO推荐敏感(≤)⁷	敏感 (≤)	中介 (=)	耐药 (≥)	EUCAST 推荐敏感 (≤)⁵
异烟肼⁸	0.2	0.2	0.25/1.0	0.1	0.1	0.1/0.4	-	0.1	0.125	0.12	-	0.25	-
链霉素⁹	4.0	4.0	4.0	1.0	1.0	1.0/4.0	-	-	-	-	-	-	-
乙胺丁醇⁹	2.0	2.0	2.0	5.0	5.0	5.0/7.5	-	-	4.0	2.0	4.0	8.0	-
利福平¹⁰	40.0	40.0	40.0	1.0	0.5^*	1.0	-	0.5	0.5	0.5^*	-	1.0^*	-
吡嗪酰胺	-	-	-	100.0	100.0	100.0	-	-	-	-	-	-	-
左氧氟沙星	2.0^*	2.0^*	-	1.0	1.0	1.5	-	1.0	1.0	-	-	-	-
莫西沙星¹¹	1.0^*	1.0^*	-	0.25/1.0	0.25/1.0	0.25/2.0	-	1.0	-	-	-	-	-
贝达喹啉	-	-	-	1.0^*	1.0^*	-	-	0.25	0.125(0.25)	-	-	-	0.25^*
利奈唑胺	-	-	-	1.0	1.0	1.0	-	1.0	1.0(2.0)	-	-	-	-
氯法齐明	-	-	-	1.0^*	1.0^*	-	-	0.25	0.25(0.5)	-	-	-	-
德拉马尼	-	-	-	0.06^*	0.06^*	-	-	0.06	0.06(0.125)	-	-	-	0.06^*
阿米卡星	30.0	30.0	30.0	1.0	1.0	1.0	-	1.0	-	-	-	-	-
卡那霉素	30.0	30.0	30.0	2.5	2.5	2.5	-	4.0	4.0	-	-	-	-
氧氟沙星	4.0	-	-	2.0	-	-	-	-	-	-	-	-	-
卷曲霉素	40.0	40.0	40.0	2.5	2.5	2.5	-	-	-	-	-	-	-
乙硫异烟胺	40.0	40.0	40.0	5.0	5.0	-	-	-	4.0	-	-	-	-
丙硫异烟胺	40.0	40.0	40.0	2.5	2.5	-	-	-	-	-	-	-	-
对氨基水杨酸	1.0	-	1.0	-	-	4.0	-	-	-	-	-	-	-
环丝氨酸	-^#	-^#	-^#	-	-	-	-	-	32.0(64.0)	-	-	-	-
普瑞玛尼	-	-	-	-	-	-	2.0^*	-	-	-	-	-	-