长治地区结核分枝杆菌的耐多药性研究

Survey on multiple drug-resistance to mycrobacteria in Changzhi region

目的分析长治地区结核分枝杆菌耐药性的特点,了解其耐多药菌的流行情况。方法采用分离培养,菌种鉴定。并对鉴定的结核分枝杆菌利用绝对浓度法进行耐药性测定。结果在长治地区500例结核病人的临床标本中,分离出结核分枝杆菌168株,阳性分离率为33.6%。168株结核分枝杆菌对14种抗痨药物的耐药性分别为:无耐药32株,为19.0%;耐1种药32株,为19.0%;耐2种药48株,为28.6%;耐3种药16株,为9.5%;耐4、5种药各4株,为2.4%;耐6、7、10种药各2株,为1.2%;耐8、9种药各4株,为2.4%;耐11种药18株,为10.7%。耐两种以上药104株,为59.9%;在168株中,农村分离菌株101株(60.1%),城镇67株(39.9%);在耐多药104菌株中,农村的为34株,为32.7%,城镇70株,为67.3%。结论长治地区耐多药性结核分枝杆菌所占比例较大,对结核病的流行产生严重的影响。农村的结核病发病率高于城镇,城镇的耐多药菌株高于农村。

Objective To survey the characteristics of drug-resistance to mycrobacteria in Changzhi region and find out the prevalence situation of multiple drug-resistant bacteria.Methods Mycrobacteria were isolated,cultured and identified.The drug-resistance of identified mycrobacteria was detected by absolute concentration method.Results Of clinical samples from 500 patients with tuberculosis in Changzhi region,mycrobacteria were isolated from 168 cases,and the positive rate was 33.6%.The resistance to 14 drugs of anti-tuberculosis in 168 strains was as follows：32 stains（19.0%）had no resistance to any drug;32（19.0%）resistant to one drug;48（28.6%）to two drugs;16（9.5%）to three drugs;4（2.4%）to four drugs,4（2.4%）to five drugs,4（2.4%）to eight drugs,4（2.4%）to nine drugs;and 2（1.2%）to six,2（1.2%）to seven,2（1.2%）to ten drugs;18（10.7%）to eleven drugs.In a word,59.9% of the 168 strains were resistant to more than two kinds of drugs.In all isolated mycrobacteria,101 strains（60.1%）were isolated from rural patients and 67（39.9%）from the urban.Among 104 strains of multiple drug-resistance,34（32.7%）were from the rural and 70（67.3%）from the urban.Conclusion The multiple drug-resistance mycrobacteria were superior in the Changzhi region,which results in more serious tuberculosis prevalence.The incidence of tuberculosis in the rural is higher than that in the urban,but drug-resistant strains from urban are more than ones from rural.