1156株结核分枝杆菌临床分离株耐药情况分析  

Analysis of drug resistance of 1156 clinical isolates of Mycobacterium tuberculosis

作　　者：易俊莉[1] 杨新宇[1] 陈昊 赵琰枫 陈双双 张洁[1] 丁北川[1] 代小伟 孙闪华[1] 武文清[1] 李传友 YI Jun-li;YANG Xin-yu;CHEN Hao;ZHAO Yan-feng;CHEN Shuang-shuang;ZHANG Jie;DING Bei-chuan;DAI Xiao-wei;SUN Shan-hua;WU Wen-qing;LI Chuan-you(Beijing Research Institute for Tuberculosis Control,Beijing 100035,China)

机构地区：[1]北京结核病控制研究所,100035

出　　处：《中国防痨杂志》2021年第7期677-681,共5页Chinese Journal of Antituberculosis

基　　金：首都卫生发展科研专项(2018-1-1041)。

摘　　要：目的分析北京市结核病防治机构(简称"结防机构")管理的肺结核患者结核分枝杆菌临床分离株耐药情况,为北京市结核病防治工作提供依据。方法对2019年1—12月北京市各结防机构收集的1241株分枝杆菌培养阳性临床分离株采用对硝基苯甲酸/噻吩-2-羧酸肼(PNB/TCH)生长试验法进行初步菌种鉴定,使用比例法进行8种抗结核药物的药物敏感性试验,药品包括异烟肼(INH)、利福平(RFP)、链霉素(Sm)、乙胺丁醇(EMB)、左氧氟沙星(Lfx)、阿米卡星(Am)、卷曲霉素(Cm)、对氨基水杨酸(PAS)。结果 1241株分枝杆菌培养阳性临床分离株中,结核分枝杆菌(MTB)1156株,占93.15%,非结核分枝杆菌(NTM)85株,占6.85%。1156株MTB分离株总耐药率为24.83%(287/1156),RFP耐药率为7.27%(84/1156),多耐药率为6.75%(78/1156),耐多药率为5.28%(61/1156),准广泛耐药率为1.73%(20/1156),广泛耐药率为0.17%(2/1156)。8种抗结核药物的耐药顺位依次为Sm(17.91%,207/1156)>INH(11.76%,136/1156)>RFP(7.27%,84/1156)>EMB(4.84%,56/1156)>Lfx(4.76%,55/1156)>PAS(2.16%,25/1156)>Cm(1.47%,17/1156)>Am(0.69%,8/1156)。耐药谱共有43种,包括单药耐药7种、耐多药6种、准广泛耐药8种、广泛耐药1种、多耐药21种。结论北京市结防机构管理的结核病患者临床分离株耐药谱呈现复杂性和多样性,应重视结核病患者的耐药筛查,加强耐药结核病患者的治疗管理。Objective Analyze the drug resistance of clinical isolates of Mycobacterium tuberculosis(MTB)in pulmonary tuberculosis patients managed by the Beijing tuberculosis prevention and control institutions to support the prevention and treatment of tuberculosis in Beijing. Methods The 1241 positive isolates of mycobacteria from January to December in 2019 all came from the Beijing tuberculosis prevention and control institutions.Identification(PNB/TCH growth test)and drug susceptibility tests of M.tuberculosis(the proportion method for 8 antituberculosis drugs)were carried out.Drugs for sensitivity tests included INH,RFP,Sm,EMB,Lfx,Am,Cm and PAS. Results Among the 1241 mycobacteria positive isolates in 2019,1156(93.15%)strains were MTB,and85(6.85%)strains were non-tuberculous mycobacteria(NTM).Among the 1156 MTB isolates,the total drug resistant rate was 24.83%(287/1156).The drug-resistant rate was 7.27%(84/1156),6.75%(78/1156),5.28%(61/1156),1.73%(20/1156)and 0.17%(2/1156)for RFP,PDR,MDR,Pre-XDR and XDR respectively.The order of resistance to 8 anti-tuberculosis drugs was Sm(17.91%,207/1156)>INH(11.76%,136/1156)>RFP(7.27%,84/1156)>EMB(4.84%,56/1156)>Lfx(4.76%,55/1156)>PAS(2.16%,25/1156)>Cm(1.47%,17/1156)>Am(0.69%,8/1156).There were 43 types of drug-resistant profiles,including 7 monoresistant,6 MDR,8 Pre-XDR,1 XDR,21 PDR. Conclusion The drug resistance profiles of clinical isolates of tuberculosis patients managed by the Beijing tuberculosis prevention and control institutions are diverse and complex.We should strengthen the screening of drug-resistant tuberculosis patients for the management and treatment of drug-resistant tuberculosis patients preferably.

关 键 词：分枝杆菌 结核 细菌学技术 微生物敏感性试验 抗药性 细菌 流行病学研究 

分 类 号：R446.5[医药卫生—诊断学]