西藏自治区非结核分枝杆菌耐药特点及临床特征初步分析

Preliminarily Analyse on the Characteristics of Drug Resistance and Clinical Symptoms of Non-Tuberculosis Mycobacterium Infection in Tibet

目的探讨西藏自治区非结核分枝杆菌(NTM)的耐药情况及临床特点。方法收集2008年3月至2010年7月西藏自治区疾病预防控制中心结核病实验室从患者痰标本分离培养的分枝杆菌培养物,用PNB/TCH鉴别培养基培养进行菌种鉴定,采用WHO推荐的比例法进行4种一线药物异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)和链霉素(SM)的药敏试验,并结合临床资料分析NTM病例的临床特征。结果共收集到412株分枝杆菌培养物,经鉴定,非结核分枝杆菌18株,占4.4%。对INH、RFP、SM和EMB的耐药率分别为88.9%、77.8%、94.4%和22.2%。耐多药率为77.8%。总耐药率100%。临床主要症状为咳嗽、咳痰、发热、咯血等;肺部病变范围广,以中年患者多见。结论西藏自治区结核病病原同样存在NTM,NTM对INH、RFP和SM不敏感。NTM肺病的治疗方案有待规范。

Objective To explore the drug resistant situation and clinical features of non-tuberculosis mycobacterium（NTM） infection in Tibet.Methods From March 2008 to July 2010,412 strains isolated from sputum were identified and conducted drug susceptibility test in laboratory in Tibet Center for Disease Control and Prevention,and the clinical data of 18 patients infected with NTM were analyzed.Results 18 strains of NTM was identified from 412 strains of mycobacterium,occupied 4.4%.The drugs（INH,RFP,SM and EMB） resistant rate was 88.9%,77.8%,94.4% and 22.2% respectively.The multi-drug resistant rate was 77.8%,and the total rate of drugs resistantance was100%.The main symptoms of patients infected NTM were cough,expectoration,fever and haemoptysis and so on.And wide range of lung had pathological change when the patients infected NTM,which was more common in the middle-aged patients.Conclusions NTM also exist in Tibet autonomous region.NTM was resistant to INH,RFP and SM.And the treatment programs of lung disease by NTM is need to be regularized.