美罗培南对非结核分枝杆菌的体外抑菌效果评价

doi:10.3969/j.issn.1000-6621.2019.03.011

摘要/Abstract

摘要：

目的评价美罗培南(meropenem,MEM)对非结核分枝杆菌(non-tuberculous mycobacteria,NTM)的体外抑菌效果。方法收集首都医科大学附属北京胸科医院2015年1月至2016年12月分离的NTM临床分离株,共计207株。采用微孔板Alamar Blue 法测定MEM对纳入的207株NTM临床分离株的体外抑菌效果。同时,评价其对46种NTM标准株[30株快生长分枝杆菌(rapidly growing mycobacterium,RGM)和16株慢生长分枝杆菌(slowly growing mycobacterium, SGM)]的体外抑菌情况。结果在30株RGM标准菌株中,26.7%(8/30)的菌种对MEM耐药。MEM对偶发和脓肿分枝杆菌临床分离株的耐药率分别为33.3%(11/33)和82.5%(33/40)。在16株SGM标准株, 56.3%(9/16)的菌株对MEM耐药。在SGM 临床分离株中,MEM对戈登分枝杆菌、胞内分枝杆菌、鸟分枝杆菌和堪萨斯分枝杆菌的耐药率分别依次为20.0%(2/10)、63.9%(23/36)、72.7%(16/22)和95.6%(43/45)。结论 MEM对于大多数RGM菌种和部分SGM菌种都显示出一定的体外抑菌活性,其中对偶发分枝杆菌和戈登分枝杆菌则显示出相对较好的体外抑菌活性。

关键词: 分枝杆菌, 非典型性, 微生物敏感性试验, 结果评价(卫生保健), 美罗培南

Abstract:

Objective The main goal of this study was to evaluate the in vitro inhibitory activity of meropenem against non-tuberculous mycobacteria (NTM).Methods Alamar Blue Assay was performed with micro-well plate to determine the Minimal Inhibitory Concentrations (MICs) of 207 NTM strains against meropenem. The strains consisted of different NTM species and were isolated from January 2015 to December 2016 in Beijing Chest Hospital, Capital Medical University. Furthermore, 46 reference strains were also tested, which included 30 rapidly rowing mycobacterium (RGM) species and 16 slowly growing mycobacterium(SGM) species.Results Among the 30 tested RGM species, 26.7% (8/30) were resistant to meropenem. The meropenem resistant rates of clinical isolates of M.fortuitum and M.abscessus were 33.3% (11/33) and 82.5% (33/40), respectively. Meropenem exhibited moderate activities against SGM species. Among the 16 tested SGM species, 56.3% (9/16) were resistant to meropenem. The meropenem resistant rates of clinical isolates of M.gordonae, M.intracellulare, M.avium and M.kansassii were 20.0% (2/10), 63.9%(23/36),72.7%(16/22), and 95.6%(43/45), respectively. Conclusion This study demonstrated that meropenem had inhibitory activities against the majority RGM species and some SGM species in vitro, while had relatively better inhibitory activities against M.gordonae and M.fortuitum.

Key words: Mycobacteria, atypical, Microbial sensitivity tests, Outcome assessment (health care), Meropenem

于霞,罗晶晶,赵立平,徐洋,梁倩,马异峰,董玲玲,黄海荣. 美罗培南对非结核分枝杆菌的体外抑菌效果评价[J]. 中国防痨杂志, 2019, 41(3): 302-307. doi: 10.3969/j.issn.1000-6621.2019.03.011

Xia YU,Jing-jing LUO,Li-ping ZHAO,Yang XU,Qian LIANG,Yi-feng MA,Ling-ling DONG,Hai-rong HUANG. In vitro activity of meropenem against non-tuberculous Mycobacteria[J]. Chinese Journal of Antituberculosis, 2019, 41(3): 302-307. doi: 10.3969/j.issn.1000-6621.2019.03.011

图/表 3

表1

MEM对30株RGM标准菌株和16株SGM标准菌株的MIC情况

标准菌株号		拉丁文名称	中文名称	MIC(μg/ml)
RGM 菌种
ATCC 19977		Mycobacterium abscessus	脓肿分枝杆菌	64
ATCC 27406		Mycobacterium agri	田野分枝杆菌	16
ATCC 27280		Mycobacterium aichiense	爱知分枝杆菌	0.25
ATCC 23366		Mycobacterium aurum	金色分枝杆菌	2
ATCC 33464		Mycobacterium austroafricanum	南非分枝杆菌	>64
ATCC 14472		Mycobacterium chelonae	龟分枝杆菌	>64
ATCC 19627		Mycobacterium chitae	千田分枝杆菌	0.5
ATCC 27278		Mycobacterium chubuense	楚布分枝杆菌	8
DSM 44829		Mycobacterium cosmeticum	美容品分枝杆菌	2
ATCC 19340		Mycobacterium diernhoferi	迪氏分枝杆菌	0.5
ATCC 35219		Mycobacterium fallax	诡诈分枝杆菌	>64
ATCC 6841		Mycobacterium fortuitum	偶发分枝杆菌	4
ATCC 27726		Mycobacterium gadium	加地斯分枝杆菌	0.25
ATCC 43909		Mycobacterium gilvum	浅黄分枝杆菌	4
ATCC BAA-955		Mycobacterium goodii	古德分枝杆菌	4
DSM 44124		Mycobacterium mucogenicum	产黏液分枝杆菌	1
ATCC 25795		Mycobacterium neoaurum	新金色分枝杆菌	1
ATCC 27023		Mycobacterium obuense	奥布分枝杆菌	32
ATCC 19686		Mycobacterium parafortuitum	副偶发分枝杆菌	8
DSM 43271		Mycobacterium peregrinum	外来分枝杆菌	0.25
ATCC 11758		Mycobacterium phlei	草分枝杆菌	32
ATCC 33776		Mycobacterium porcinum	猪分枝杆菌	2
ATCC 35154		Mycobacterium pulveris	灰尘分枝杆菌	0.25
ATCC 35796		Mycobacterium senegalense	塞内加尔分枝杆菌	8
ATCC 700731		Mycobacterium septicum	败血症分枝杆菌	0.25
ATCC 25275		Mycobacterium simiae	猿分枝杆菌	0.25
ATCC 19420		Mycobacterium smegmatis	耻垢分枝杆菌	2
ATCC 19527		Mycobacterium thermoresistibile	抗热分枝杆菌	4
ATCC 27282		Mycobacterium tokaiense	东海分枝杆菌	1
ATCC 15483		Mycobacterium vaccae	母牛分枝杆菌	16
标准菌株号	拉丁文名称		中文名称	MIC(μg/ml)
SGM 菌种
ATCC 25276	Mycobacterium asiaticum		亚洲分枝杆菌	8
ATCC 25291	Mycobacterium avium		鸟分枝杆菌	64
DSM 44243	Mycobacterium celatum		隐蔽分枝杆菌	16
ATCC 15754	Mycobacterium gastri		胃分枝杆菌	0.5
ATCC 14470	Mycobacterium gordonae		戈登分枝杆菌	0.25
ATCC 13950	Mycobacterium intracellulare		胞内分枝杆菌	64
ATCC 12478	Mycobacterium kansasii		堪萨斯分枝杆菌	64
ATCC 19422	Mycobacterium microti		田鼠分枝杆菌	2
ATCC 19530	Mycobacterium nonchromogenicum		不产色分枝杆菌	1
DSM 44648	Mycobacterium parascrofulaceum		副偶发分枝杆菌	32
ATCC 19981	Mycobacterium scrofulaceum		瘰疬分枝杆菌	64
ATCC 35799	Mycobacterium szulgai		苏尔加分枝杆菌	0.5
ATCC 15755	Mycobacterium terrae		土分枝杆菌	64
ATCC 23292	Mycobacterium triviale		次要分枝杆菌	>64
ATCC 27294	Mycobacterium tuberculosis (H37Rv)		结核分枝杆菌	2
ATCC 19250	Mycobacterium xenopi		蟾分枝杆菌	64

表1

图1

表2

参考文献 17

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分类	拉丁名称	中文名称	菌株数量	MIC (μg/ml)
SGM	Mycobacterium arupense	阿普罗分枝杆菌	4	0.5(1),16(1),>64(2)
	Mycobacterium xenopi	蟾分枝杆菌	4	32(4)
	Mycobacterium szulgai	苏尔加分枝杆菌	3	16(2),32(1)
	Mycobacterium parascrofulaceum	副瘰疬分枝杆菌	1	16(1)
	Mycobacterium terrae	土分枝杆菌	1	>64(1)
	Mycobacterium malmoense	玛尔摩分枝杆菌	1	8(1)
RGM	Mycobacterium chelonae	龟分枝杆菌	3	0.25(1),4(1),>64(1)
	Mycobacterium holsaticum	荷尔斯泰因分枝杆菌	1	>64
	Mycobacterium massiliense	马赛分枝杆菌	3	>64(3)