浙江省衢州市分枝杆菌菌种鉴定和耐药现状研究  

Identification and drug resistance of Mycobacteria in Quzhou, Zhejiang

作　　者：郑芳[1] 余秋明[1] 王胜 邱悦波 余旭良[1] ZHENG Fang;YU Qiu-ming;WANG Sheng;QIU Yue-bo;YU Xu-liang(Central Laboratory of Quzhou People's Hospital,Quzhou,Zhejiang 324000)

机构地区：[1]衢州市人民医院中心实验室,浙江衢州324000

出　　处：《中国预防医学杂志》2019年第3期191-194,共4页Chinese Preventive Medicine

基　　金：浙江省科技计划项目(2016C33238)

摘　　要：目的了解衢州市分枝杆菌菌种分布和耐药情况,为结核病防治提供参考依据。方法选取2014-2017年衢州市各结核病定点医院上送衢州市人民医院的2 384株分枝杆菌菌株,采用PNB/TCH(P-Nitro benzoic acid/thiophene-2-carboxylic acid)生长试验进行菌种鉴定,对四种一线抗结核药物:异烟肼(isoniazid,INH)、利福平(rifampicin,RFP)、乙胺丁醇(ethambutol,EMB)、链霉素(streptomycin,SM)进行耐药性监测。结果 2 384株分枝杆菌经过鉴定,结核分枝杆菌2 270株(95.22%),非结核分枝杆菌(nontuberculosis mycobacterial,NTM)114株(4.78%);2 270株结核分枝杆菌总耐多药率为5.51%;复治患者的总耐药率、耐多药率以及对INH、RFP、EMB、SM任一药物的耐药率均高于初治患者,差异有统计学意义(均P<0.01);单一耐药的前3位为SM>INH>RFP;多耐药和耐多药的前3位为INH+RFP+SM>INH+SM>INH+RFP。结论衢州市的复治患者的耐药情况较为严重,需进一步改善结核病的预防控制工作。Objective To understand the distribution and drug resistance of mycobacteria in Quzhou, and to provide reference for tuberculosis control. Methods 2 384 mycobacteria strains were collected from designated hospitals in Quzhou from 2014 to 2017.PNB/TCH(P-Nitro benzoic acid/thiophene-2-carboxylic acid) growth test was used to identify strains.Drug resistance was performed on isoniazid(INH), Rifampicin(RFP), Ethambutol(EMB), and Streptomycin(SM). Results 2 384 mycobacteria strains were identified, including 2 270(95.22%) mycobacterium tuberculosis strains and 114(4.78%) Nontuberculosis mycobacterial(NTM) strains.As for the 4 first-line anti-tuberculosis drugs and the multidrug resistance rate was 5.51%.The total drug resistance rate, the multidrug resistance rate and the resistance rate of single drug among INH, RFP, EMB and SM in retreated patients were significantly higher than those in newly treated patients.The difference between them was statistically significant(P<0.01).The top three single drug resistance rate was SM>INH>RFP;The top three of multi-drug resistant and multidrug resistant were INH+RFP + SM>INH + SM>INH+RFP. Conclusions Current situation of the drug resistance of the retreated patients in Quzhou is serious.It is necessary to further improve the prevention and the control of tuberculosis.

关 键 词：肺结核 分枝杆菌 PNB/TCH生长试验 药敏 耐药率 耐多药 

分 类 号：R183[医药卫生—流行病学]