摘要目的 对耐多药MTB临床分离株进行利福布汀和利福平交叉耐药性研究分析,为利福布汀治疗耐多药MTB提供依据.方法 在96孔板上检测利福布汀和利福平对99株耐多药MTB菌株的90％最低抑菌浓度(MIC90),交叉耐药率数据分析采用x2检验,两组间MIC比较经对数转化后采用独立样本t检验.结果 利福布汀和利福平的交叉耐药率为85.9％(85/99).利福布汀的MIC90值为≤16 mg/L,中位数为2 mg/L;利福平的MIC9o值为≥2 mg/L,中位数＞32 mg/L,利福布汀MIC90值仅为利福平的1/8 ～ 1/32.利福布汀和利福平交叉耐药率随利福平的耐药程度加大而上升,低耐利福平组和中耐利福平组的交叉耐药例数分别为0/9和5/9,而高耐利福平组几乎全部交叉耐药(98.8％,80/81).结论 利福布汀对利福平耐药MTB菌株有一定的抗菌活性,可作为利福类药物耐药结核病的可选择药物.

abstractsObjective To study the cross-resistance between rifampin and rifabutin in multidrug resistant Mycobacterium tuberculosis complex strains,and therefore to provide laboratory data for using rifabutin in the treatment of multidrug resistant tuberculosis.Methods The MIC90 of rifabutin and rifampin against 99 multidrug resistant Mycobacterium tuberculosis clinical strains were determined by microplate assays.Statistical analysis was performed by using the x2 test and the t test.Results The cross-reaistance rate between rifampicin and rifabutin was 85.9％ (85/99),but the MIC90 of rifabutin ( ≤16 mg/L,median 2 mg/L) was significantly lower than that of rifampicin ( ≥2 mg/L,median ＞32 mg/L).The crossresistance rate increased with the resistance level of rifampicin.The cross-resistance strains in the lower and the medium groups were 0/9 and 5/9 respectively,while the strains of the high rifampicin-resistant group were almost all cross-resistant (98.8％,80/81 ).Conclusion Rifabutin had activities against rifampin resistant Mycobacterium tuberculosis complex strains in vitro,and therefore may be used as an alternative for the treatment of multidrug resistant tuberculosis.