在Mycobacterium abscessus复杂肺病中培养转化和宏抗性
Suting Chen1, Shengjuan Bao1,2, Jifang Zheng1
1Beijing Key Laboratory for Drug-Resistant Tuberculosis Research, National Clinical Laboratory on Tuberculosis, Beijing Chest Hospital, affiliated Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China.
Microbiology spectrum
|September 2, 2025
概括
在治疗 Mycobacterium abscessus复杂性肺病 (MABC- PD) 方面,克拉里素 (CLA) 比亚齐素 (AZI) 更有效. 与AZI相比,CLA在体外表现出更好的敏感性和更慢的诱导性耐药性发展.
科学领域:
- 微生物学
- 传染性疾病
- 药理学
背景情况:
- 由于抗生素耐药性较高,Mycobacterium abscessus复合体 (MABC) 导致肺部疾病 (MABC-PD),其治疗具有挑战性.
- 亚齐素 (AZI) 和清素 (CLA) 等宏类药物是主要的治疗方法,但它们的比较疗效和耐药性发展仍在争论中.
研究的目的:
- 将AZI和CLA与临床MABC分离物的体外有效性进行比较.
- 评估诱导性和获得性类抗药性的发展.
- 在MABC-PD患者中评估耐药性与治疗结果之间的关联.
主要方法:
- 在MABC分离物中确定了AZI和CLA的最小抑制度 (MIC).
- 诱导性和获得性耐药性的发病率与基因转录的发病率进行了比较.
- 在接受宏类药物治疗的61名MABC- PD患者中监测了培养率.
主要成果:
- 对于MABC分离物,AZI的MIC比CLA高4-8倍.
- 诱导性宏化物耐药性,特别是在具有功能性 erm 的 Mycobacterium abscessus 中,在 AZI 中比 CLA 发展得更快.
- 患有抗药性分离物 (erm(41) 或 rrl 突变的患者的培养转化率较低.
结论:
- 在实验室敏感性和诱导性耐药性模式有利于CLA而不是AZI用于MABC- PD治疗.
- 在MABC-PD的治疗失败中,宏化物耐药性机制有显著的作用.
- 了解耐药性概况对于优化MABC-PD治疗至关重要.
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