新疆地区93株耐多药结核分枝杆菌耐药情况分析

Analysis on multi-drug resistance of Mycobacterium tuberculosis in Xinjiang

目的分析新疆地区耐多药结核分枝杆菌的耐药情况,为指导耐多药结核病的治疗提供依据。方法收集新疆地区2009-2011年经常规药敏试验发现的耐多药结核分枝杆菌(MDR-TB)临床分离菌株,用HX-21细菌鉴定/药敏诊断试剂板检测对链霉素、乙胺丁醇、氧氟沙星、左氧氟沙星、阿米卡星、卷曲霉素、丙硫异烟胺、力克肺疾、克拉霉素、环丙沙星、利福布丁、氯法齐明、利奈唑胺、磺胺甲氧嗪等14种药物的药物敏感性。结果 93株MDR-TB菌中对一线药物链霉素和乙胺丁醇的耐药率分别为48.39%(45/93)和15.05%(14/93),对二线药物利福布丁的耐药率最高为51.61%(48/93),卷曲霉素耐药率最低为1.08%(1/93);仅耐异烟肼和利福平的为10.75%(10/93),对除异烟肼和利福平以外的药物耐药情况中同时耐2种药物的比例最高为25.81%(24/93);交叉耐药中氨基糖甙类链霉素和阿米卡星交叉耐药率最低为6.45%(6/93),氧氟沙星和环丙沙星交叉耐药率为12.90%(12/93),利福平和利福布丁交叉耐药率最高为51.61%(48/93);XDR-TB菌株占6.45%(6/93)。结论新疆地区耐多药结核分株杆菌的耐药情况比较严重,对一、二线药物都有较高的耐药率,并且利福平和利福布丁交叉耐药率也相对较高,所以在治疗中要避免耐药性的产生及交叉耐药。

Objective To analyze multidrug resistance （MDR） of Mycobacterium tuberculosis （M. tuberculosis） isolated from Xinjiang, to provide evidence for the treatment of multi drug resistant tuberculosis （MDR TB）. Methods A total of 93 MDR M. tuberculosis clinical strains which were identified by routine drug susceptibility testing with proportion method were collected from 2009 to 2011 for the drug sensitivity to 14 drugs including streptomycin, ethambutol, ofloxacin, levofloxacin, amikacin, capreomycin, protionamide, pasiniazide, clarithromycin, ciprofloxacin, rifabutin, clofazimine, linezolid and sulfamethoxazole using HX21 bacterial identification and drug susceptibility test plate. Results For the firstline drugs, the resistant rates to streptomycin and ethambutol were 48.39% （45/93） and 15.05% （14/93）, and for the secondline drugs, the highest resistance rate was 51.61% （48/93） to rifabutin, while the lowest rate was 1.08% （1/93） to capreomycin. There were 10 （10.75%） strains resistant to both isoniazid and rifampicin. Except for isoniazid