105株脓肿分枝杆菌临床分离菌株对10种抗菌药物的敏感性分析

Drug sensitivity of 105 clinical isolates of Mycobacterium abscessus to 10 antibacterial drugs

目的 分析脓肿分枝杆菌临床分离菌株对10种抗菌药物的敏感性,为脓肿分枝杆菌病的治疗提供参考依据。方法 收集湖南省胸科医院2019-2020年分离鉴定出的脓肿分枝杆菌临床菌株,采用微孔药敏板最小抑菌浓度试验,检测脓肿分枝杆菌对磺胺甲恶唑、利奈唑胺、环丙沙星、亚胺培南、莫西沙星、头孢西丁、阿米卡星、克拉霉素、妥布霉素和强力霉素(多西环素)共10种抗菌药物的敏感性。结果 共收集脓肿分枝杆菌临床分离菌株105株。结果显示,脓肿分枝杆菌对阿米卡星、克拉霉素敏感性高,分别为98.10%和93.33%;对利奈唑胺的敏感性为78.10%,而其他药物的敏感性均低于50%。脓肿分枝杆菌对强力霉素的耐药性最强,耐药率为84.76%;其对磺胺甲恶唑、环丙沙星和亚胺培南的耐药率也较高,分别为75.24%、74.28%、72.38%。96.19%(101/105)的菌株同时对多种抗菌药物耐药。结论 脓肿分枝杆菌对抗菌药物的耐药率较高。阿米卡星、克拉霉素及利奈唑胺可作为临床治疗脓肿分枝杆菌病的优选抗菌药物。最好是在药敏试验下进行精准抗感染治疗。

Objective To analyze the drug sensitivity of clinical isolates of Mycobacterium abscessus(M. abscessus) to 10 kinds of antibiotics and to provide reference for the treatment of M. abscessus disease. Methods Clinical strains of M. abscessus isolated and identified in Hunan Chest Hospital from 2019 to 2020 were collected and microporous drug-sensitive plate minimum inhibitory concentration(MIC) test was performed for detecting the susceptibility of M. abscessus to 10 antibiotics including Sulfamethoxazole, Linezolid, Ciprofloxacin, Imipenem, Moxifloxacin, Cefoxitin, Amikacin, Clarithromycin,Tobramycin and Doxycycline(Doxycycline). Results A total of 105 clinical isolates of M. abscessus were collected. The results showed that M. abscessus was high sensitivity to Amikacin and Clarithromycin, accounted for 98.10% and 93.33%respectively. The sensitivity of M. abscessus to linezolid was 78.10%, while the sensitivity of the other drugs was less than 50%. M. abscessus had the strongest resistance to Doxycycline, of which the resistance rate was 84.76%. The drug resistance rates of Sulfamethoxazole, Ciprofloxacin and Imipenem were also high, which were 75.24%, 74.28% and 72.38%,respectively. 96.19%(101/105) of the strains were resistant to multiple antibiotics simultaneously. Conclusion M. abscessus has a high rate of resistance to antibiotics. Amikacin, Clarithromycin and Linezolid can be used as the best antibiotics for clinical treatment of M. abscessus disease. It is best to carry out precise anti-infection treatment under sensitivity test.