213例抗酸杆菌菌种鉴定及药敏试验的临床研究  

Clinical Study of Species Identification and Drug Susceptibility Tests of Acid-Fast Bacilli in 213 patients

作　　者：吴玉姣[1] 秦科宇 朱珊梅[1] 张志新[2] WU Yu-jiao;QIN Ke-yu;ZHU Shan-mei;ZHANG Zhi-xin(Department of Pharmacy, Changzhou NO. 3 hospital, Changzhou 213000, China;Department of Pulmonary disease, Changzhou NO. 3 hospital, Changzhou 213000, China)

机构地区：[1]江苏省常州市第三人民医院药剂科,常州213000 [2]江苏省常州市第三人民医院肺科,常州213000

出　　处：《海峡药学》2018年第6期41-43,共3页Strait Pharmaceutical Journal

基　　金：常州四药临床药学科研基金(编号:CY20130032)

摘　　要：目的探讨常州地区抗酸杆菌的菌种分布及其药敏情况,为临床诊断及治疗提供科学依据。方法选取常州第三人民医院于2015年5月~2016年7月期间收集抗酸杆菌培养阳性菌株213例,用L-J培养基进行菌种鉴定;采用绝对浓度法对6种抗结核药物异烟肼、利福平、乙胺丁醇、链霉素、左氧氟沙星、丁胺卡那进行药敏试验。结果 213例抗酸杆菌中结核分枝杆菌(MTB)占87.32%(186/213),非结核分枝杆菌(NTM)占12.68%(27/213)。MTB对6种药物全部敏感者达62.90%(117/186),单一耐药18.82%(35/186),耐多药10.22%(19/186),泛耐药4.84%(9/186),耐左氧氟沙星22.04%(41/186)。16例有药敏结果的NTM分别为25%(4/16)、0(0),43.75%(7/16),50.00%(8/16),56.25%(9/16)。NTM耐药率明显高于MTB(P<0.05)。MTB、NTM对6种药物均存在低浓度耐药而高浓度敏感现象,发生频率为(4.98%~17.89%)和(16.77%~49.90%)。结论常州地区的结核病耐药率较高,NTM耐药率显著高于MTB,应当重视抗酸杆菌菌种的鉴定和药敏检测,这对于临床研究和应用十分必要。OBJECTIVE The aim of this study is to investigate the bacterial species of acid-fast bacilli distribution and the susceptibility to anti-tuberculosis drugs in Changzhou region,and provide scientific evidence for clinical diagnosis and treatment. METHODS Primary bacterial species identification by L-J culture medium and susceptibility tests to six kinds of anti-tuberculosis drugs（ isoniazid,rifampin,ethambutol,streptomycin,levofloxcin and amikacin） by absolute concentration method were performed on 213 culture-positive strains of acid-fast bacilli which were isolated in Chang Zhou NO. 3 hospital from May 2015 to July 2016. RESULTS（1）Mycobacterium tuberculosis（ MTB） and non-tuberculous mycobacteria（ NTM） accounted for 87. 32%（ 186/213） and 12. 68%（ 27/213）,respectively.（2）For MTB,the rate of sensitivity to all six kinds of anti-tuberculosis drugs was 62. 90%（ 117/186）,and the rates of mono-drug resistance,multi-drug resistance,extensively drug resistance and LFX resistance were 18. 82%（ 35/186）,10. 22%（ 19/186）,4. 84%（ 9/186）,and 22. 04%（ 41/186） respectively; for NTM（ only 13 strains of them had the results of drug susceptibility tests）,the rates of items mentioned above were 25%（ 4/16）,0（ 0）,43. 75%（ 7/16）,50. 00%（ 8/16） and 56. 25%（ 9/16） in turns. NTM had much higher rate of resistance to anti-tuberculosis drugs than MTB（ P〈0. 05）. Both MTB and NTM were resistant to six kinds of anti-tuberculosis drugs in lower concentrations,while were sensitive to them in higher concentrations. And the frequency of such phenomenon varied from 4. 98% to 17. 89% and 16. 77% to 49. 90% respectively. CONCLUSION The prevalence of drug-resistant tuberculosis is severe in Chang Zhou region,and NTM has much higher rate of resistance to anti-tuberculosis drugs than MTB; the bacterial species identification and the drug susceptibility tests of acid-fast bacilli are very important and necessary to clinical research and practice.

关 键 词：抗酸杆菌 结核分枝杆菌 非结核分枝杆菌 菌种鉴定 药物敏感试验 

分 类 号：R965[医药卫生—药理学]