110株结核分支杆菌对喹喏酮类药物的药敏试验分析

Analysis of susceptibility testing for 110 strains of Mycobacterium tuberculosis to quinolones

目的 分析 110株结核分支杆菌对环丙沙星 (CPLX )、氧氟沙星 (OFLX)、左氧氟沙星(LVFX)、司帕沙星 (SPFX)的药敏试验结果。方法 采用 2倍稀释法 ,改良罗氏培养基进行药敏试验。结果 4 9例初治病人耐药率 :CPLX 4 % ,OFLX 8% ,LVFX 2 % ,SPFX 6 % ;5 2例耐多药菌株耐药率 :CPLX 5 2 % ,OFLX 4 4% ,LVFX 2 2 % ,SPFX 10 % ;110株结核分支杆菌总耐药率 :CPLX2 6 .2 % ,OFLX 2 4 .7% ,LVFX 10 .5 % ,SPFX 7.2 %。交叉耐药率 2 3.6 %。结论 (1)初治结核病人 ,抗炎治疗尽量避免使用喹喏酮类药物 ;(2 )复治结核病人要选择合理治疗方案 ,避免假联合用药 ;(3)应用喹喏酮类药物 ,剂量要足 ,疗程要够 ;(4 )建议将喹喏酮类药列入结核分枝杆菌常规药敏试验中。

Objective To analyze the drug susceptibility testing for 110 strains of M.tuberculosis to quinolones.Methods The drug susceptibility testing (DST) was performed by the tube doubling dilution method, and reformed L-J medium was used.Results The resistance rates of 49 cases with newly diagnosed pulmonary tuberculosis were CPLX 4%, OFLX 8%, LVFX 2% and SPFX 6% . The resistance rates to CPLX, OFLX, LVFX and in the 52 cases with MDR-TB were 52%, 44%, 22%, and 10% respectively , The total resistance rate of 110 strains of MTB were CPLX 26.2%, OFLX 24.7%, LVFX 10.5% and SPLX 7.2%, The cross resistance rate was 23.6%. Conclusion 1.Avoid to give the quinolones as anti-in flammatory treatment on newly diagnosed cases with pulmonary tuberculosis;2.Only use reasonable chemotherapy regimens for the retreated cases with pulmonary tuberculosis;3.To give the full dosage and must complete the full course of treatment with the quinolones;4.The drug susceptibility test to quinolones as the routine assay is necessary.