目的:检测天津地区近年来泌尿生殖道沙眼衣原体临床分离株对喹诺酮类药物莫西沙星的药物敏感性,筛查耐药株,以及体外莫西沙星与阿奇霉素、莫西沙星与米诺环素的相互作用情况。方法:将经McCoy细胞培养法检测出的41例沙眼衣原体临床株,传代培养至感染率达90%以上,通过微量稀释法进行莫西沙星、阿奇霉素和米诺环素3种抗菌药物的药敏试验,以及棋盘稀释法测定莫西沙星与阿奇霉素、莫西沙星与米诺环素两组抗菌药物联合后的体外相互作用情况。结果:在体外,莫西沙星最低抑菌浓度(MIC)为0.03—0.24mg/L。莫西沙星与阿奇霉素体外联合时对51.22%的临床株为协同和相加作用:莫西沙星与米诺环素联合时对85.37%的临床株为拮抗作用。结论:在体外,莫西沙星与阿奇霉素联用.其抗菌活性均明显提高.因此为反复或持续的泌尿生殖道感染患者的联合治疗奠定一定的实验基础,提示联合用药的疗效可能优于单用一种抗菌药物,同时可以降低对喹诺酮类药物耐药的发生;相反,莫西沙星与米诺环素联合应用时,它们之间的拮抗作用将极大地降低各自的抗菌活性。联合药敏试验在一定程度上能够弥补单独药敏试验的一些不足。
Objective: To test the in vitro activity of moxifloxacin against Chlamydia trachomatis in recent clinical isolates from urogenital infection, and the interactions between moxifloxacin, azithromycin and minocyline. Methods: When more than 90% McCoy cells were infected, the tested forty-one strains were collected to investigate the minimal inhibitor concentrations (MICs) of three antimicrobials respectively, using microdilution assay. Checkerboard array was used to calculate the fractional inhibitory concentrations (FICs) and then detected the interactions in the various combinations ofantimicrobials. Results: For all isolates, the MIC range of moxifloxacin was 0.03-0.24 mg/L. In vitro, synergism and additively effect of moxiiloxacin-azithromycin combination was found in 51.22% strains. However, antagonism effect of moxifloxacin-minocyline combination was observed in 85.37% strains, Conclusions: These resuhs indicate that the combination of moxifloxacin with azithromycin is more effective against Chlamydia trachomatis than either individual antimicrobial, such combination might be recommended in recurrent or persistent infection of Chlamydia trachomatis. However, the combination of moxifloxacin with minocyline exhibits antagonistic activity against Chlamydia trachomatis and declined sensitivity. Combined sensitivity test can compensate for some shortcomings of individual susceptibility test to a certain extent.