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Erythromycin과 tetracycline에 저항성인 Myoplasma pneumoniae의 quinolone계 항생물질에 대한 감수성

Susceptibilities of Quinolones against Erythromycin- and Tetracycline-Resistant Mycoplasma pneumoniae Isolates

  • 장명웅 (고신대학교 의과대학 미생물학교실) ;
  • 박인달 (고신대학교 의과대학 미생물학교실) ;
  • 김광혁 (고신대학교 의과대학 미생물학교실)
  • Chang, Myung-Woong (Department of Microbiology, Kosin University College of Medicine) ;
  • Park, In-Dal (Department of Microbiology, Kosin University College of Medicine) ;
  • Kim, Kwang-Hyuk (Department of Microbiology, Kosin University College of Medicine)
  • 발행 : 2006.08.30

초록

호흡기 질환 환자로부터 분리된 M. pneumoniae 123 균주를 tetracycline에 저항성인 tetM 유전자만을 가진 36균주, erythromycin에만 저항성 변이를 일으킨 39균주, tetracycline과erythromycin에 저항성인 21균주, erythromycin과 tetracycline에 감수성인 27균주로 나누어 quinolone 제제와 macrolides계 항생제에 대한 감수성 검사를 시험관 희석법으로 실시하여 다음과 같은 결론을 얻었다. Tetracycline에만 저항성인 M. pneumoniae 36균주의 moxifloxacin, levofloxacin, sparfloxacin, ofloxacin, ciprofloxacin, amikacin, clarithromycin에 대한 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 15.6과 $1.56\;{\mu}g/ml$ 이었다. Erythromycin에만 저항성인 39균주의 $MIC_{90}$은 각각 0.06, 0.39, 0.125, 1.0, 1.0, 15.6과 $25.0\;{\mu}g/ml$ 이었다. Tetracycline과 erythromycin에 모두 저항성인 21 균주의 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 3.9,과 $1.56\;{\mu}g/ml$ 이었다. Tetracycline과 erythromycin에 모두 감수성인 27 균주의 $MIC_{90}$은 각각 0.125, 0.39, 0.125, 1.0, 1.0, 7.8과 $0.09\;{\mu}g/ml$ 이었다. 이상의 결과로 moxifloxacin, levofloxacin, sparfloxacin 과 같은 quinolone 계 항생물질은 tetracycline이나 erythromycin에 단독 혹은 모두에 저항성인 M. pneumoniae 균주에도 감수성이었으므로 이들 균에 의한 감염증의 치료에 이용할 수 있는 약제이었으나, ofloxacin, ciprofloxacin, clarithromycin 등의 약제 선택에는 항생물질에 대한 감수성검사를 실시하여 적절한 항생제를 선택하는 등의 각별한 주의가 요망된다.

The in vitro activities of quinolones were determined with 36 strains of tetracycline- resistant, 39 strains of erythromycin-resistant, 21 strains of both resistant to tetracycline and erythromycin, and 27 strains of both susceptible to tetracycline and erythromycin of the M. pneumoniae isolates which have been isolated and classified in previous studies. The $MIC_{90}$ of moxifloxacin, levofloxacin, sparfloxacin, ofloxacin, ciprofloxacin, amikacin, and clarithromycin against 36 strains of tetracycline-resistant M. pneumoniae isolates were 0.125, 0.39, 0.125, 1.0, 1.0, 15.6, and $1.56\;{\mu}g/ml$, respectively. The $MIC_{90}$ against 39 strains of eryhtromycin-resistant M. pneumoniae isolates were 0.06, 0.39, 0.125, 1.0, 1.0, 15.6, and $25.0\;{\mu}g/ml$, respectively. The $MIC_{90}$ against 21 strains of both resistant to tetracycline and eryhtromycin of M. pneumoniae isolates were 0.125, 0.39, 0.125, 1.0, 1.0, 3.9, and $1.56\;{\mu}g/ml$, respectively. The $MIC_{90}$ against 27 strains of both susceptible to tetracycline and eryhtromycin of M. pneumoniae isolates were 0.125, 0.39, 0.125, 1.0, 1.0, 7.8, and $0.09\;{\mu}g/ml$, respectively. These result suggest that moxifloxacin, levofloxacin, and sparfloxacin of the quinolones might be promising antimicrobial agents for the treatment of tetracycline- and erythromycin-resistant M. pneumoniae infection. However, selection of ofloxacin, ciprofloxacin, and clarithromycin for the treatment of M. pneumoniae infection should be cautious decision with antimycoplasmal susceptibility test.

키워드

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