tbjournalТуберкулез и социально значимые заболеванияTuberculosis and socially significant diseases2413-03462413-0354ООО «Ин-Тренд10.54921/2413-0346-2024-12-2-30-35tbjournal-124Research ArticleДИАГНОСТИКА ТУБЕРКУЛЕЗАDIAGNOSIS OF TUBERCULOSISАктивность клофазимина в отношении клинических изолятов Mycobacterium tuberculosis с различным спектром лекарственной устойчивости к противотуберкулезным препаратамActivity of clofazimine against clinical isolates of Mycobacterium tuberculosis with different spectrum of drug resistance to anti-tuberculosis drugsМихайловаЮ. Д.MikhailovaYu. D.

Михайлова Юлия Дмитриевна – ведущий научный  сотрудник отдела проблем лабораторной  диагностики туберкулеза и патоморфологии,  кандидат биологических наук

107014, г. Москва, ул. Стромынка, д. 10, стр. 1

Тел. +7 (499) 268-70-33

juliaisaeva81@rambler.ruМакароваМ. В.MakarovaM. V.

Макарова Марина Витальевна – главный научный сотрудник отдела проблем лабораторной диагностики туберкулезаи патоморфологии, доктор биологических наук

107014, г. Москва, ул. Стромынка, д. 10, стр. 1

Тел. +7 (916) 688-98-25

makarova75@yandex.ruКрыловаЛ. Ю.KrylovaL. Yu.

Крылова Людмила Юрьевна – ведущий научный  сотрудник отдела проблем лабораторной  диагностики туберкулеза и патоморфологии, кандидат биологических наук

107014, г. Москва, ул. Стромынка, д. 10, стр. 1

Тел. +7 (499) 268-70-33

luda.yurievna2017@yandex.ruСафоноваС. Г.SafonovaS. G.

Сафонова Светлана Григорьевна – заведующая  отделом проблем лабораторной диагностики  туберкулеза и патоморфологии, доктор биологических наук

107014, г. Москва, ул. Стромынка, д. 10, стр. 1

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safonova.s.g@inbox.ruЛитвиновВ. И.LitvinovV. I.

Литвинов Виталий Ильич – научный руководитель,  доктор медицинских наук, профессор, академик РАН

107014, г. Москва, ул. Стромынка, д. 10, стр. 1

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mnpcbtlv@yandex.ruГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»РоссияMoscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health DepartmentRussian Federation2024300620241223035Copyright © Михайлова Ю.Д., Макарова М.В., Крылова Л.Ю., Сафонова С.Г., Литвинов В.И., 20242024Михайлова Ю.Д., Макарова М.В., Крылова Л.Ю., Сафонова С.Г., Литвинов В.И.Mikhailova Y.D., Makarova M.V., Krylova L.Y., Safonova S.G., Litvinov V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tb-journal.ru/jour/article/view/124

В связи с широким распространением лекарственной устойчивости M. tuberculosis необходима оценка возможности использования в этиотропном лечении туберкулеза препаратов с антимикобактериальной активностью, ранее применявшихся при другой патологии, в частности, клофазимина.Цель. Определение фенотипической чувствительности к клофазимину клинических штаммов M. tuberculosis с разным спектром лекарственной устойчивости к другим препаратам.Материал и методы. Изучали чувствительность к клофазимину для 75 клинических штаммов методом серийных микроразведений в жидкой питательной среде Миддлбрука 7H9 (50 штаммов с сохраненной лекарственной чувствительностью, 25 – с МЛУ и пре-ШЛУ), с оценкой МИК50, МИК90 и эпидемиологического пограничного значения МИК (ECOFF).Результаты. Концентрации клофазимина в диапазоне от 0,06 до 0,125 мкг/мл подавляли рост большинства штаммов M. tuberculosis (в 76%); концентрации 0,125 и 0,25 мкг/мл ингибировали соответственно рост 50% (МИК50) и 90% (МИК90) лекарственно-чувствительных штаммов, 0,125 и 0,5 мкг/мл – лекарственно-устойчивых. Значение ECOFF составило 0,25 мкг/мл.Заключение. Клофазимин даже в низких концентрациях ингибирует размножение клинических штаммов M. tuberculosis независимо от спектра их чувствительности к другим антимикобактериальным препаратам. Полученные данные служат дополнительным основанием для применения клофазимина в комплексном лечении туберкулеза, в том числе с МЛУ и ШЛУ возбудителя.

Due to the widespread drug resistance of M. tuberculosis (MTB), it is necessary to assess the possibility of using drugs with antimycobacterial activity previously used in other pathologies, e.g. clofazimine, in anti-tuberculosis chemotherapy regimens.The aim was to determine the phenotypic sensitivity to clofazimine of clinical strains of MTB with different spectrum of drug resistance.Methods. Clofazimine sensitivity was studied for 75 MTB clinical strains by serial microdilutions in Middlebrook 7H9 liquid medium (50 were drug-susceptible, 25 have MDR and pre-XDR), with estimation of MIC50, MIC90 and epidemiologic cut-off value of MIC (ECOFF).Results. The growth of most MTB strains (76%) was suppressed by clofazimine concentrations ranging from 0.06 to 0.125 μg/ml. The growth of 50% (MIC50) and 90% (MIC90) of drug-sensitive strains was inhibited by clofazimine concentrations of 0.125 and 0.25 μg/ml, respectively, while the growth of drug-resistant strains was inhibited by 0.125 and 0.5 μg/ml, respectively. The ECOFF value was 0.25 μg/ml.Conclusion. Clofazimine even in low concentrations inhibits the growth of MTB clinical strains regardless of sensitivity to other antimycobacterial drugs. The obtained data serve as an additional basis for the use of clofazimine in the complex treatment of tuberculosis, including MDR and XDR pathogens.

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The authors declare that there are no conflicts of interest present.