目的 对德拉马尼(delamanid,DLM)和普瑞玛尼(pretomanid,PMD)两种硝基咪唑类抗结核新药的药物敏感性进行分析比较,为临床使用提供更多数据支持.方法 收集2021年11月至2023年2月重庆市39个区(县)送至重庆市结核病防治所的培养阳性分离株,采用简单随机抽样的方法,选取经菌种鉴定和比例法药敏试验确定的198株耐多药结核(multi-drug-resistant tuberculosis,MDR-TB)分离株,采用微量肉汤稀释法对DLM和PMD进行药敏试验,分析比较药敏结果.结果 在198株MDR-TB临床分离株中,DLM、PMD的基线耐药率分别为5.1％(10/198)、3.5％(7/198),DLM的MIC值主要集中于0.016～0.06 μg/mL,PMD的MIC值主要位于0.03～2 μg/mL.在13株硝基咪唑类药物耐药株中,DLM耐药10株,PMD耐药7株,两者交叉耐药4株(30.8％,4/13).结论 DLM和PMD对MDR-TB临床分离株均有较强的体外抑菌活性,DLM的抑菌效果更强,但两者基线耐药的出现提示我们应在用药前进行药敏试验.
This study analysed and compared the drug susceptibility of two nitroimidazoles drugs delamanid(DLM)and pretomanid(PMD)against multidrug-resistant tuberculosis(MDR-TB)isolates in vitro,so as to provide more datas for the clinical application.Culture positive isolates from 39 county TB dispensary were collected and sent to Chongqing Institute for Tuberculosis Control from November 2021 to February 2023.A total of 198 MDR-TB isolates based on simple random sam-pling were confirmed by strain identification and proportional susceptibility test,and the minimum inhibitory concentrations(MICs)of DLM and PMD were performed by broth microdilution testing.Among the 198 MDR isolates,the baseline resist-ance rates of DLM and PMD were 5.1％(10/198)and 3.5％(7/198)respectively.The MICs range of DLM and PMD against the 198 MDR-TB strains were mainly concentrated in 0.06～1 μg/mL and 0.03～2 μg/mL,respectively.Among the 13 nitroi-midazole resistant isolates,10 isolates were resistant to DLM,7 resistant to PMD,and 4(30.8％,4/13)showed cross-resist-ance between DLM and PMD.In conclusion,DLM and PMD showed excellent antibacterial activities against MDR-TB clinical isolates in vitro.DLM has lower MICs than that of PMD.However,the occurrence of baseline resistance in both new drugs suggested that drug susceptibility testing should be performed prior treatment.
刘文果;朱大冕;冯鑫;沈静;孔珏颖;伏宣霖;胡彦
重庆市结核病防治所,重庆 400050
临床医学
结核分枝杆菌;德拉马尼;普瑞玛尼;药物敏感性;耐多药
Mycobacterium tuberculosis;delamanid;pretomanid;drug susceptibility;MDR
《中国人兽共患病学报》 2024 (003)
247-252,256 / 7
重庆市科卫联合医学科研项目(No.2022MSXM102,No.2022-MSXM066);重庆市首批公共卫生重点学科(专科)([2022]72) Supported by Chongqing Medical Scientific Research Project(No.2022MSXM102,No.2022MSXM066)and the First Batch of Key Disciplines On Public Health in Chongqing([2022]72)
10.3969/j.issn.1002-2694.2024.00.045
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