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结核分枝杆菌菌株的耐药谱和耐药程度同时增加
Concomitant increases in spectrum and level of drug resistance in Mycobacterium tuberculosis isolates
Sun Z, Zhang J, Song H, Zhang X, Li Y, Tian M, Liu Y, Zhao Y, Li C  2010/11/22 13:49:00 
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International Journal of Tuberculosis and Lung Disease, 2010, Volume 14, Issue 11 
 

OBJECTIVE: To determine the drug resistance spectrum and resistance levels of extensively drug-resistant (XDR-) and multidrug-resistant tuberculosis (MDR-TB) and TB resistant to either rifampicin (RMP, R) or isoniazid (INH, H; R/H-DR). DESIGN: Of 142 drug-resistant clinical isolates examined, 13 were XDR-TB, 66 were MDR-TB and 63 were R/H-DR. The drug resistance spectrum was tested by the absolute two-concentration method. Minimum inhibitory concentrations (MICs) were determined for the strains by agar dilution method on Löwenstein-Jensen slants. RESULTS: The drug resistance spectrum of XDR-TB, MDR-TB and R/H-DR TB isolates ranged from 4 to 9, 2 to 6 and 1 to 5 drugs, respectively. Over half of all XDRTB (53.8%), MDR-TB (66.7%) and R/H-DR (54.0%) isolates were resistant to two other anti-tuberculosis drugs; 38.5% of XDR-TB, 24.2% of MDR-TB and 28.6% of R/H-DR TB isolates were resistant to ≥3 additional anti-tuberculosis drugs in addition to those originally defined, demonstrating that the MIC values and the proportions of strains with higher MICs followed a trend of XDR-TB > MDR-TB > R/H-DR for INH, RMP, ofloxacin and ethambutol. CONCLUSION: XDR-TB, MDR-TB and R/H-DR TB isolates exhibited both increasingly broader resistance spectra and a higher percentage of strains with high MICs to more frequently resistant drugs, which might be related to patterns of TB chemotherapy. © 2010 The Union.

 
 
Correspondence Address: Li, C.; Department of Bacteriology and Immunology, Beijing Tuberculosis and Thoracic Tumour Research Institute, Tongzhou District, Beijing 101149, China; email:lichuanyou6688@hotmail.com 
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 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者,女,69岁。2009年1月无明显诱因下出现乏力,当时程度较轻,未予以重视。2009年3月患者乏力症状加重,尿色逐渐加深,大便习惯改变,颜色变淡。4月18日入我院感染科治疗,诉轻度头晕、心慌,体重减轻10kg。无肝区疼痛,无发热,无腹痛、腹泻、腹胀、里急后重,无恶性、呕吐等。入院半月前于外院就诊,查肝功能:ALT 601IU/L,AST 785IU/L,TBIL 97.7umol/L,白蛋白 41g/L,甲状腺功能:游离T3 30.6pmol/L,游离T4 51.9pmol/L,心电图示快速房颤。
 

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友情链接:中文版柳叶刀 | MD CONSULT | Journals CONSULT | Procedures CONSULT | eClips CONSULT | Imaging CONSULT | 论文吧 | 世界医学书库 医心网 | 前沿医学资讯网

公司简介 | 用户协议 | 条件与条款 | 隐私权政策 | 网站地图 | 联系我们

 互联网药品信息服务资格证书 | 卫生局审核意见通知书 | 药监局行政许可决定书 
电信与信息服务业务经营许可证 | 京ICP证070259号 | 京ICP备09068478号

Copyright © 2009 Elsevier.  All Rights Reserved.  爱思唯尔版权所有