摘要
目的:探究苏州地区结核菌阳性患者中非结核分枝杆菌(NTM)的检出及其耐药情况,为临床用药提供参考。方法:抽取2015年1月—2018年12月间4年间收治的结核分枝杆菌(MTB)培养阳性9359例患者资料,统计其采用对硝基苯甲酸(PNB)鉴别培养基培养鉴定的分枝杆菌培养和药敏结果,分析其结核分枝杆菌的检出及其对不同抗结核药物的耐药性。结果:9359例阳性患者标本中分离出9359株结核分枝杆菌,其中MTB 8142株和NTM 1217株分别占87.00%和13.00%;NTM检出率分别为2015年—2018年分别为12.85%、10.59%、13.85%和14.09%,出现小幅波动;在1217例NTM患者中具有一线药敏结果,其耐药率依次为异烟肼(INH,95.15%)、链霉素(SM,88.66%)、利福平(RFP,66.64%)和乙胺丁醇(EMB,26.54%);在1217例患者中有524例NTM具有二线药敏结果,其耐药率依次为对氨基水杨酸钠(PAS,97.71%)、阿米卡星(AK,81.87%)、左氧氟沙星(LVF,71.56%)和乙硫异烟胺(TH,16.22%);NTM对SM的耐药率随时间的延长缓慢下降趋势。结论:苏州地区NTM检出率低于全国第五次结核病流行病学调查结果,NTM的耐药率较高,仍需采取有效的防控措施,以确保患者用药的有效性。
Objective:To investigate the detection and drug resistance of non-tuberculous Mycobacterium(NTM)in tuberculous(TB)positive patients in Suzhou area,and to provide reference for clinical drug use.Methods:Data of 9359 patients with positive Mycobacterium tuberculosis(MTB)culture from January 2015 to December 2018 were collected,and the results of mycobacterium tuberculosis culture and drug sensitivity identified by culture medium using para-nitrobenzoic acid(PNB)were calculated to analyze the detection of MTB and its resistance to different anti-TB drugs.Results:Among the 9359 positive patients,9359 strains of MTB were isolated,in which 8142 strains of MTB and 1217 strains of NTM accounted for 87.00%and 13.00%,respectively.The NTM detection rate was 12.85%,10.59%,13.85%and 14.09%from 2015 to 2018,showing small fluctuations.In 1217 NTM patients,there were firstline drug sensitivity results,and the drug resistance rates were isoniazid(INH,95.15%),streptomycin(SM,88.66%),rifampicin(RFP,66.64%)and ethambutol(EMB,26.54%)respectively.In the 1217 patients,524 had second-line drug sensitivity results,and the drug resistance rates were para-aminosalicylate sodium(PAS,97.71%),amikacin(AK,81.87%),levofloxacin(LVF,71.56%)and 2-ethylthioisonicotinamide(TH,16.22%).The resistance rate of NTM to SM decreased slowly with time.Conclusion:The detection rate of NTM in Suzhou region is lower than the results of the 5 th national epidemiological survey of tuberculosis,and the drug resistance rate of NTM is higher,so effective prevention and control measures still need to be taken to ensure the effectiveness of drug use in patients.
作者
钱宇迪
宋华峰
赵静
薛静
胥萍
QIAN Yu-di;SONG Hua-feng;ZHAO Jing;XUE Jing;XU Ping(Inspection Center,The No.5 People's Hospital of Suzhou,Suzhou Jiangsu 215131,China;Suzhou Key Laboratory of of Tuberculosis Control,Suzhou Jiangsu 215131,China)
出处
《抗感染药学》
2020年第5期656-658,共3页
Anti-infection Pharmacy
基金
苏州市科技局项目(编号:SS2019074)。
作者简介
钱宇迪(1990-),女,检验师,E-mail:506650847@qq.com;通信作者:胥萍(1973-),女,主任技师.联系电话:18262165898。