贵州省某专科医院非结核分枝杆菌的菌种鉴定及耐药检测分析  

Identification and drug resistance analysis of nontuberculous mycobacteria in a specialized hospital in Guizhou province

作　　者：秦万 郭生琼[2] 欧维正 徐勇 杨儒斌 QIN Wan;GUO Shengqiong;OU Weizheng;XU Yong;YANG Rubin(Department of Inspection Division,Guiyang Public Health Clinical Center,Guiyang,Guizhou 550024,China;Department of Tuberculosis Control,Guizhou Center for Disease Control and Prevention,Guiyang,Guizhou 550004,China)

机构地区：[1]贵阳市公共卫生救治中心检验科,贵州贵阳550024 [2]贵州省疾病预防控制中心结防所防治科,贵州贵阳550004

出　　处：《安徽医药》2024年第8期1608-1612,共5页Anhui Medical and Pharmaceutical Journal

基　　金：贵州省科技厅基础研究计划(黔科合基础〔2020〕1Y355)。

摘　　要：目的探讨非结核分枝杆菌(NTM)的菌种鉴定分布及耐药性,为临床诊治提供参考依据。方法搜集2017―2020年贵州某专科医院微量肉汤稀释法药敏试验对-硝基苯甲酸(PNB)培养基阳性的疑似NTM菌株,经聚合酶链式反应(PCR)-荧光探针法初步鉴定为NTM后,用基因芯片法进行菌种鉴定,采用微量肉汤稀释法进行15种药物测试。结果贵州地区流行的100例NTM菌株经鉴定分为10种菌型类别。其中,占比最高者为龟/脓肿分枝杆菌48%(48/100),其后依次为鸟分枝杆菌16%(16/100),堪萨斯分枝杆菌12%(12/100),胞内分枝杆菌11%(11/100)。药敏结果显示100株NTM总耐药率61.8%,龟/脓肿分枝杆菌耐药率最高76.4%,其后依次为微黄分枝杆菌73.3%、偶然分枝杆菌55.6%、鸟分枝杆菌53.8%和戈登分枝杆菌53.3%。男女病人比例为63∶37,男性耐药率56.1%;女性耐药率71.5%。结论贵州地区有10种NTM菌种流行,龟/脓肿分枝杆菌是该地区NTM优势菌种。不同菌种间耐药率差异较大,龟/脓肿分枝杆菌耐药率最高。男性病人多于女性,女性耐药率高于男性。应用快速NTM菌种鉴定和药敏试验,可为NTM防控项目的决策者提供参考依据,有助于促进医务人员对抗NTM药物的科学选择。Objective To explore the identification,distribution and drug resistance of nontuberculous mycobacteria,and to provide reference for clinical diagnosis and treatment.Methods Suspected NTM strains with positive PNB culture medium were collected from a specialized hospital in Guizhou from 2017 to 2020.After being preliminarily identified as NTM by PCR-fluorescence probe method,the strains were identified by gene chip method,and 15 drugs were tested bybroth microdilution method.Results The 100 NTM strains circulating in Guizhou were classified into 10 types,of which the highest proportion was 48%(48/100)of M.chelonae/M.bscessus,followed by M.avium 16%(16/100),M.Kansasii 12%(12/100),M.intracellulare 11%(11/100).The results of drug sensitivity showed that the total drug resistance rate of 100 NTM strains was 61.8%,and the highest drug resistance rate was 76.4%,followed by Mycobacterium flavum 73.3%,Mycobacterium fortuitum 55.6%,Mycobacterium avium 53.8%and Mycobacterium Gordon 53.3%.The ratio of male to female patients was 63∶37,and the male drug resistance rate was 56.1%.The female drug resistance rate was 71.5%.Conclusions There are 10 kinds of NTM strains prevalent in this area,and Mycobacterium tortoise/abscess is the dominant NTM strain in this area.The drug resistance rate varies greatly among different strains,and the drug resistance rate of Mycobacterium chelonei/Abscess is the highest.There are more male patients than female,and the drug resistance rate of female is higher than that of male.The application of rapid NTM strain identification and drug sensitivity test can provide reference for the decision makers of NTM prevention and control projects,and help to promote the scientific choice of anti-NTM drugs for medical staff.

关 键 词：非结核分枝杆菌 菌种鉴定 药物敏感试验 微量肉汤稀释法 基因芯片法 

分 类 号：R446.5[医药卫生—诊断学]