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Title: [Antimicrobial susceptibility and genotyping of Mycobacterium intracellulare].
Author: Wang SQ, Jiang GL, Wei GM, Huo FM, Dong LL, Zhao LP, Huang HR, Wang GR.
Journal: Zhonghua Jie He He Hu Xi Za Zhi; 2018 Jul 12; 41(7):539-543. PubMed ID: 29996350.
Abstract:
Objective: To investigate the antimicrobial susceptibility and genotyping of Mycobacterium intracellulare. Methods: A total of 150 M. intracellulare isolates were collected. The susceptibility against 15 antimicrobial agents widely used for treatment of non-tuberculosis mycobacteria (NTM) infections, was tested by broth microdilution assay. Variable number of tandem repeats (VNTR) assay was also performed using the 16-loci genotyping method. Results: The drug susceptibility test revealed that clarithromycin (97.3%, 146/150), moxifloxacin (94.0%, 141/150) and amikacin (90.0%, 135/150) had the best antimicrobial activities in vitro against the M. intracellulare isolates. Secondly, 75.3%(113/150), 64.0%(96/150), 52.7%(79/150) and 8.7%(13/150) of the strains were susceptible to rifampicin, linezolid, capreomycin, and ethambutol, respectively. The MIC(50) and MIC(90) values of the 3 injectable anti-tuberculosis drugs were as follows: amikacin 4 mg/L and 16 mg/L, streptomycin 4 mg/L and 16 mg/L, capreomycin 8 mg/L and 16 mg/L. The MIC(50) and MIC(90) values of the 5 different fluoroquinolones were 0.5 mg/L and 2 mg/L for moxifloxacin , 1 mg/L and 8 mg/L for ciprofloxacin, 1 mg/L and 8ug/ml for levofloxacin, 2 mg/L and 16 mg/L for antoflolxacin, 2 mg/L and 16 mg/L for ofloxacin. The Hunter-Gaston Discriminatory Index (HGDI) value for the 16-loci VNTR typing of M. intracellulare isolates was 0.994. VNTR differentiated the 150 isolates into 21 clusters and acquired a total of 121 unique patterns. Drug resistance profile was not independently associated with cluster strains. Conclusions: Clarithromycin, moxifloxacin and amikacin had the best antimicrobial activities in vitro against M. intracellulare isolates. The 16-loci VNTR typing revealed a highly discriminatory power and drug resistance profile was not independently associated with cluster strains. 目的： 分析我国胞内分枝杆菌临床分离株的耐药谱及基因型特征，为治疗胞内分枝杆菌感染性疾病提供科学依据。 方法： 纳入2013—2015年北京胸科医院150株胞内分枝杆菌临床分离株，采用微孔板Alamar Blue法测定胞内分枝杆菌对15种药物的最低抑菌浓度(MIC)，以确定其药物的敏感度；对16个可变数目串联重复序列(VNTR)位点进行PCR扩增和产物电泳分析，使用BioNumerics软件对菌株进行聚类分析，以确定其基因型特征。使用SPSS 19.0软件对结果进行统计分析，应用χ(2)检验分析不同组间耐药率的差别。 结果： 药敏试验结果显示，克拉霉素(97.3%，146/150)、莫西沙星(94.0%，141/150)和阿米卡星(90.0%，135/150)对胞内分枝杆菌具有较好的抗菌活性；75.3%(113/150)、64.0%(96/150)、52.7%(79/150)和8.7%(13/150)的菌株对利福平、利奈唑胺、卷曲霉素和乙胺丁醇敏感；3种注射类抗结核药物的MIC(50)与MIC(90)值为：阿米卡星4和16 mg/L，链霉素4和16 mg/L，卷曲霉素8和16 mg/L；5种氟喹诺酮类药物的MIC(50)与MIC(90)值为：莫西沙星0.5和2 mg/L，环丙沙星1和8 mg/L，左氧氟沙星1和8 mg/L，安妥沙星2和16 mg/L，氧氟沙星2和16 mg/L。采用16位点VNTR方法对胞内分枝杆菌进行基因分型，150株胞内分枝杆菌共分为21个簇，121种基因型，总Hunter－Gaston指数为0.997。 结论： 克拉霉素、莫西沙星和阿米卡星在体外对胞内分枝杆菌具有较好的抗菌活性；16位点VNTR方法对胞内分枝杆菌临床分离株的分辨率较高；胞内分枝杆菌的耐药谱与菌株是否成簇并无明显相关性。.

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