574例结核病病例细菌学检验结果分析

Analysis of bacteriology test result of 574 TB suspected patients

目的了解西安市分支杆菌病原菌感染的流行状况,为制定结核病防治措施提供科学依据。方法采用流行病学抽样调查方法,选取陕西省西安市为调查点,于2005年5～8月对其13个区级结防所就诊的所有病人进行调查,每个病人收集三份痰标本。采用痰涂片和痰培养法检测病人痰标本,鉴别培养基培养法鉴定分支杆菌菌种。结果574位病人,涂片阳性113人,阳性率为19.69%,培养阳性病人150人,阳性率26.13%。后者明显高于前者,两者之间的差异具有显著统计学意义(!2=360.50,P<0.01),两者联合阳性率为26.83%。从137例病例痰标本中分离到251株分支杆菌菌株,结核分支杆菌、牛分支杆菌、非结核分支杆菌(NTM)和混合感染的比例分别是67.88%、5.84%、11.68%、14.60%。结论细菌培养法可明显提高阳性率;NTM感染流行状况应予以足够的重视。

Objective This study was designed to investigate the prevalence situation of Mycobacterium infection in Xi＇an City, Shanxi Province and provide a scientific basis of tuberculosis prevention and therapeutic measure. Methods Xi＇an City was choosed as the investigatory city for this study and the sample investigation was carded out. All the sputum specimens were collected from the suspected patients who suffered from TB. Sputum samples were tested by smear slide microscopy and culture method. The clinical isolate strains were determined to the species of Mycobacterium by the identified media. Results 574 suspect patients were tested. The number of smear positive and culture positive was 113 （19.69%） and 150 （26.13%） respectively. There was significant difference between the two methods （x^2=360.50,P〈0.01）. 154 patients were diagnosed with tuberculosis by smear or culture positive result, the positive rate was 26.83%.251 strains isolated from 137 patients in which the infection rate was 67.88%, 5.84%, 11.68% and 14.60% by MTB, M.bovis, NTM, and mix infected by two species of mycobacterium respectively. Conclusion The sensitivity of sputum culture is much better than that of smear slide microscopy method. The prevalence situation of NTM infection must be pay more attention especially.