[A study of beta-lactamase activity of mycobacteria and clinical trial of penicillin/beta-lactamase inhibitor combinations in the treatment of drug-resistant Mycobacterium tuberculosis].
Beta-lactamase activity was determined using a nitrocefin disc method on 34 Mycobacterium tuberculosis (M. tuberculosis) strains and 13 nontuberculous mycobacteria strains. In the 34 M. tuberculosis strains, 23 strains showed beta-lactamase activity. In 10 Mycobacterium avium complex strains, no beta-lactamase activity was detected. In the Mycobacterium chelonae strains, all three strains examined showed strong beta-lactamase activity. No correlation was found between beta-lactamase activity and resistance to anti-tuberculous chemotherapeutic agents. Four patients who were persistently positive for multi-drug-resistant M. tuberculosis (MDR-TB) on sputum and positive in beta-lactamase activity, were treated with penicillin/beta-lactamase inhibitor combinations. In two cases, the trials were discontinued because of diarrhea; the trials were continued in the remaining two for four months, but the MDR-TB was positive during the course of the therapy. Effectiveness of the therapy with penicillin/beta-lactamase inhibitor combinations against M. tuberculosis was obscure, although many of M. tuberculosis examined showed beta-lactamase activity.
Nakagawa
Y
Y
Department of Internal Medicine, Kumamoto National South Hospital, Japan.
Shimazu
K
K
Ebihara
M
M
Aman
K
K
D000658:Amoxicillin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D019818:Clavulanic Acid / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D015269:Mycobacterium avium Complex / Q000201:enzymology*; D016926:Mycobacterium chelonae / Q000201:enzymology*; D009169:Mycobacterium tuberculosis / Q000201:enzymology* / Q000302:isolation & purification; D010406:Penicillins / Q000627:therapeutic use*; D013407:Sulbactam / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000378:metabolism
D004791:Enzyme Inhibitors; D010406:Penicillins; D065093:beta-Lactamase Inhibitors; D019818:Clavulanic Acid; D000667:Ampicillin; D000658:Amoxicillin; D001618:beta-Lactamases; D013407:Sulbactam