摘要目的:评价奈诺沙星对脓肿分枝杆菌临床分离株的体外抗菌活性。方法:收集2014—2017年上海市肺科医院分离的脓肿分枝杆菌临床菌株194株，以微量肉汤稀释法测定奈诺沙星和目前临床常用的喹诺酮类药物（莫西沙星，环丙沙星和左氧氟沙星）对脓肿分枝杆菌临床分离株的最低抑菌浓度（MIC），同时还对奈诺沙星与抗脓肿分枝杆菌常用药物（克拉霉素、阿米卡星、亚胺培南、头孢西丁、替加环素和利奈唑胺）之间的协同作用在体外进行了评估。结果:奈诺沙星对脓肿分枝杆菌的MIC范围在0.25~64.0 mg/L，MIC 50 和MIC 90分别为4和16 mg/L。奈诺沙星对大部分（68.0%，132/194）脓肿分枝杆菌的MIC≤4 mg/L，显著高于莫西沙星（51.0%，99/194； χ2=11.651， P<0.01）、环丙沙星（46.4%，90/194； χ2=18.572， P<0.01）和左氧氟沙星（25.8%，50/194； χ2=69.586， P<0.01）的MIC≤4 mg/L的菌株所占比例。除亚胺培南外，没有观察到奈诺沙星与抗脓肿分枝杆菌常用药物之间存在拮抗作用。 结论:奈诺沙星对脓肿分枝杆菌在体外存在一定的抗菌活性，且抗菌活性优于目前常用的氟喹诺酮类药物，有可能作为联合治疗脓肿分枝杆菌感染的选择之一。

abstractsObjective:To evaluate the in vitro antibacterial activity of nemonoxacin against clinical isolates of Mycobacterium abscessus ( M. abscessus). Methods:A total of 194 clinical strains of M. abscessus were collected from 2014 to 2017 in Shanghai Pulmonary Hospital. The minimum inhibitory concentrations (MICs) of nemonoxacin and other quinolones commonly used (moxifloxacin, levofloxacin and ciprofloxacin) against M. abscessus in clinic was determined by the micro-broth dilution method. Synergy between nemonoxacin and frequently used anti- M. abscessus drugs (clarithromycin, amikacin, imipenem, cefoxitin, tigecycline and linezolid) was assessed in vitro. Results:The MIC range of nemonoxacin to M. abscessus was 0.25-64.00 mg/L. The MIC 50 and MIC 90 were 4 and 16 mg/L, respectively. Most M. abscessus isolates demonstrated an MIC of ≤ 4 mg/L against nemonoxacin, with a percentage of 68.0% (132/194), which was significantly higher than that against moxifloxacin (51.0%, 99/194; χ2 = 11.651, P<0.01), ciprofloxacin (46.4%, 90/194; χ2 = 18.572, P<0.01) and levofloxacin (25.8%, 50/194; χ2 = 69.586, P<0.01), respectively. Nemonoxacin showed no antagonistic effect with commonly used anti- M. abscessus drugs, except imipenem. Conclusions:Nemonoxacin showed moderate in vitro antibacterial activity against M. abscessus, which was better than that of other fluoroquinolones commonly used in clinic at present. Therefore, nemonoxacin may be one of the options for combined treatment of M. abscessus infection.