重庆市耐多药结核分枝杆菌对贝达喹啉和德拉马尼的药物敏感性研究

Analysis of drug-susceptibility of bedaquiline and delamanid against multidrug-resistant Mycobacterium tuberculosis in Chongqing

目的分析重庆市耐多药结核分枝杆菌(multidrug-resistant Mycobacterium tuberculosis,MDR-TB)对贝达喹啉(bedaquiline,Bdq)和德拉马尼(delamanid,Dlm)的药物敏感性,以期为临床上Bdq和Dlm的合理使用提供参考。方法收集2017年11月至2018年11月间经重庆市公共卫生医疗救治中心鉴定为MDR-TB的菌株,采用微孔板法测定Bdq和Dlm的最低抑菌浓度(minimum inhibitory concentration,MIC),并对相关结果进行分析。结果所收集的111例MDR-TB临床分离株进行Bdq的药敏检测结果显示,MIC 50和MIC 90分别为0.016 mg/L和0.125 mg/L;109例MDR-TB菌株的Dlm药敏结果显示,MIC 50和MIC 90分别为0.016 mg/L和0.063 mg/L。各有5株菌株对Bdq和Dlm耐药,耐药率分别为4.50%和4.59%。不同耐药情况分组对Bdq和Dlm的耐药率与MDR-TB菌株对Bdq和Dlm的耐药率之间差异无统计学意义(P>0.05)。结论重庆市大部分MDR-TB菌株对这两种新的抗结核药物非常敏感,但不应忽视原发耐药,在制定临床治疗方案时,仍需重视对新药的药敏检测。

This study is aimed to analyze the drug-susceptibility of bedaquiline and delamanid in multidrug-resistant Mycobacterium tuberculosis in Chongqing,in order to provide reference for the proper use of bedaquiline and delamanid in clinical treatment.A total of 111 MDR-TB strains isolated from Chongqing Public Health Medical Center during Nov.2017 to Nov.2018 were collected.Minimum inhibitory concentrations(MIC)of Bdq and Dlm against these isolates were detected and analyzed.Drug susceptibility test of Bdq for 111 MDR-TB isolates with the MIC 50 and MIC 90 was 0.016 mg/L and 0.125 mg/L,and drug resistant rate of Bdq was 4.50%(5/111).Drug susceptibility test of Dlm for 109 MDR-TB isolates indicated that the MIC 50 and MIC 90 was 0.016 mg/L and 0.063 mg/L,and drug resistant rate of Dlm was 4.59%(5/109).There was no significant difference in Bdq and Dlm resistance between MDR-TB and the other groups of different drug resistance.In conclusion,most of the MDR-TB clinical isolates in Chongqing are susceptible to Bdq and Dlm,however,primary resistance has been already existed.Therefore,it is still necessary to pay attention to the drug susceptibility test of new drugs when developing MDR-TB treatment regimens.