脓肿分枝杆菌复合群药敏试验及耐药机制研究进展

脓肿分枝杆菌复合群是非结核分枝杆菌病中最常见的快速生长型分枝杆菌之一，对大多数抗结核药物耐药，临床治疗难度大。脓肿分枝杆菌复合群的3个亚种对多种抗生素的敏感性存在较大差异，临床实验室对其3个亚种的准确分型鉴定对于治疗药物的选择有重要价值。中华医学会结核病学分会制定了非结核分枝杆菌病诊断与治疗指南（2020版），按照美国临床和实验室标准协会（CLSI）分枝杆菌药敏试验标准（2018版）进行脓肿分枝杆菌药敏试验，建议根据药敏试验结果选用多药联合治疗方案。现就脓肿分枝杆菌复合群药敏试验及对主要治疗药物的耐药机制的研究进展进行综述。

Research progress on drug sensitivity test and drug resistance mechanism of Mycobacterium abscessus complex

Mycobacterium abscessus complex (MABC) is one of the most common fast-growing mycobacteria in nontuberculosis mycobacterial diseases. Drug resistance to most of the antituberculosis drugs makes its clinical teratment very difficult. There are great differences in the sensitivity of the three subspecies of MABC to a variety of antibiotics. The accurate typing and identification of the three subspecies in clinical laboratory is of great value for the selection of therapeutic drugs. The tuberculosis branch of Chinese Medicine Association has formulated the guideline for the diagnosis and treatment of nontuberculosis mycobacterial disease (2020 Edition), MABC susceptibility test should be carried out according to the standard of mycobacterium susceptibility test from Clinical and Laboratory Standards Institute (CLSI) of the United States (2018 Edition). It is suggested that multidrug combination therapy should be selected according to the results of drug sensitivity test. In order to provide reference for related research, this paper reviewed the progress of drug sensitivity test of MABC and its resistance mechanism to main therapeutic drugs.