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结核分枝杆菌临床分离株对三种氟喹诺酮类药物的敏感性分析研究
崔振玲，王洁，陆俊梅，汪小黎，胡忠义崔振玲、王洁、陆俊梅、汪小黎、胡忠义，同济大学附属上海市肺科医院 上海市结核病（肺）重点实验室，200433
基金项目：国家十一五传染病重大专项（2008ZX10003-02）；上海市科委课题（09415801800）；上海市卫生局课题（2008067；2007Y59）
摘 要:目的 对结核分枝杆菌（MTB）临床分离株对氧氟沙星（OFX）、左氧氟沙星（LFX）和莫西沙星（MFX）三种临床常用的氟喹诺酮类药物的敏感性进行分析研究，为临床用药提供依据。方法 本研究采用液体培养基联合MTT技术进行抗结核药物的最低抑菌浓度（MIC）检测。对来自我院不同结核病患者的163株MTB临床分离株进行OFX、LFX、MFX三种药物的MIC检测和Bactec MGIT 960药敏检测。结果 163株中OFX耐药株占35.6%；耐多药（MDR）结核菌株中，OFX耐药率为73.5%，MDR菌株中LFX耐药率超过一半以上；所有MTB菌株MFX的MIC值均≤1 μg/ml。结论 目前在MTB临床分离株中，OFX和LFX已出现较高的耐药率，值得引起临床医生的重视，MFX在MDR结核和广泛耐药（XDR）结核中显示出良好的抗菌效果，给MDR结核病的治疗带来希望。
关键词:分枝杆菌，结核； 微生物敏感性试验； 氧氟沙星； 莫西沙星
Evaluation of drug susceptibility of three kinds of fluoroquinolines on mycobacterium tuberculosis clinical isolates
CUI Zhen-ling，WANG Jie，LU Jun-mei，WANG Xiao-li，HU Zhong-yi.Shanghai Key Laboratory of Tuberculosis，Shanghai Pulmonary Hospital Affiliated to Tongji University，Shanghai 200433，China
Abstract:Objective To study the antimicrobial effect of three kinds of fluoroquinolones，ofloxacin （OFX），levofloxacin（LFX）and moxifloxacin（MFX），on mycobacterium tuberculosis clinical isolates for effective clinical use. Methods Liquid culture and MTT test were used in MIC test.MICs of three kinds of fluoroquinolones of 163 MTB strains from clinical isolates were detected. Results There were 35.6% MTB strains resistant to OFX in all strains and 73.5% MTB strains resistant to OFX in multidrug MTB strains. There were more than one half strains resistant to LFX. MICs of all strains were equal or lesser than 1 μg/ml. Conclusions There are highly resistant ratio of OFX and LFX in MTB clinical isolates. The clinical doctors need pay more attention on this phenomenon. MFX shows best antimicrobial effect and bring hope to multidrug TB patients.
Key words:Mycobacterium tuberculosis； Microbial sensitivity tests； Ofloxacin； Moxifloxacin
文献标引:崔振玲，王洁，陆俊梅，汪小黎，胡忠义.结核分枝杆菌临床分离株对三种氟喹诺酮类药物的敏感性分析研究[J/CD].中华临床医师杂志：电子版,2009,3(12):1947-1952.
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