结核与肺部疾病杂志2026，Vol.7Issue(4)：454-461,8.DOI:10.19983/j.issn.2096-8493.20260132
104株脓肿分枝杆菌复合群临床分离株体外药物敏感性特征与抗菌治疗不良反应的关联分析
In vitro antimicrobial susceptibility profiles of 104 clinical isolates of Mycobacterium abscessus complex and their associations with treatment-related adverse drug reactions
摘要
Abstract
Objective:To investigate the in vitro antimicrobial susceptibility profiles of clinical isolates of Mycobacterium abscessus complex(MABC),and to analyze the associations between targeted therapeutic medicine and clinical adverse drug reactions(ADR),thus providing evidence for precision clinical anti-infective therapy and pharmaceutical care.Methods:A total of 104 non-duplicate clinical MABC isolates and corresponding patient data were retrospectively collected from Fuzhou Pulmonary Hospital of Fujian Province between January 1,2020,and December 31,2024.Initial screening was performed using MGIT 960 system and gene chip technology,followed by subspecies identification using fluorescence PCR melting curve analysis and next-generation whole-genome sequencing.The strains were resuscitated and sub cultured in Middlebrook 7H9 medium.The in vitro susceptibilities to nine antimicrobial agents(amikacin,linezolid,clarithromycin,doxycycline,imipenem,moxifloxacin,ciprofloxacin,cefoxitin,and trimethoprim-sulfamethoxazole)were determined by the broth microdilution method.A"strain-clinical information"database was concurrently established.Fisher's exact test was employed to analyze differences in susceptibility between subspecies,while heatmaps and Sankey diagrams were used to visually display susceptibility profiles and drug-ADR association patterns.Results:Among 103 MABC isolates(excluding one M.abscessus subsp.Bolletii isolate),the highest susceptibility rate was observed for amikacin(99.0％,102/103),followed by linezolid(86.4％,89/103)and clarithromycin(83.5％,86/103).The highest resistance rate was recorded for doxycycline(64.0％,66/103).The susceptibility rates to imipenem(12.6％,13/103),moxifloxacin(29.1％,30/103),and ciprofloxacin(30.1％,31/103)were all below 31％,with notably high proportions of intermediate results(61.2％,48.6％,and 46.6％,respectively).Both M.abscessus subsp.Abscessus(n=77)and M.abscessus subsp.Massiliense(n=26)showed high susceptibility rates to amikacin(100.0％vs.96.2％),clarithromycin(81.8％vs.88.5％),and linezolid(88.3％vs.80.8％).No statistically significant differences were observed between the two subspecies for susceptibilities to the nine tested antimicrobial agents:clarithromycin(Fisher's exact probability method,P=0.272),imipenem(Fisher's exact probability method,P=0.378),moxifloxacin(x2=1.870,P=0.393),linezolid(Fisher's exact probability method,P=0.248),doxycycline(Fisher's exact probability method,P=0.693),trimethoprim-sulfamethoxazole(Fisher's exact probability method,P=0.155),amikacin(Fisher's exact probability method,P=0.253),cefoxitin(Fisher's exact probability method,P=0.086),and ciprofloxacin(x2=1.087,P=0.581).Of the 104 patients,78 received antimicrobial treatment among whom the overall incidence of ADRs was 51.3％(40/78).Association analyses revealed that rifabutin was significantly associated with liver dysfunction(OR=12.48,95％CI:2.20-132.47,FDR-corrected P=0.033)and gastrointestinal reactions(OR=5.59,95％CI:1.68-19.95,FDR-corrected P=0.033).Conclusion:This study demonstrates that amikacin,linezolid,and clarithromycin exhibit favorable in vitro inhibitory activity against MABC.In this cohort,no significant differences in the routine susceptibility distributions to the tested agents were observed between the bscessus and massiliense subspecies.In the clinical decision-making of combination therapy,in vitro susceptibility results should be integrated with ADR risk profiles,with particular attention to rifabutin-related hepatotoxicity and gastrointestinal reactions,to enhance treatment safety.关键词
分枝杆菌感染/微生物敏感性试验/抗菌药/药物毒性Key words
Mycobacterium infections/Microbial sensitivity tests/Anti-bacterial agents/Drug toxicity分类
医药卫生引用本文复制引用
吴迪,陈木兴,陈新朝,黄明翔,陈晓红..104株脓肿分枝杆菌复合群临床分离株体外药物敏感性特征与抗菌治疗不良反应的关联分析[J].结核与肺部疾病杂志,2026,7(4):454-461,8.基金项目
福州市科技计划项目(2022-S-030) （2022-S-030）
福州市卫生健康中青年人才科研项目(2025-S-rc5) （2025-S-rc5）
福建省卫健委青年科研项目(2025QNA092) （2025QNA092）
福建省科技计划引导性项目(2024D002) Fuzhou Science and Technology Plan Project(2022-S-030) （2024D002）
Young and Middle-aged Talents Research Project of Fuzhou Municipal Health Commission(2025-S-rc5) （2025-S-rc5）
Young Investigator Research Project of Fujian Provincial Health Commission(2025QNA092) （2025QNA092）
Guiding Project of Fujian Provincial Science and Technology Plan(2024D002) （2024D002）
