HIV/TB双重感染患者结核分枝杆菌的培养及药敏分析

Culture and antibiotic sensitivity analysis of Mycobacterium tuberculosis in patients with HIV/TB dual infection

目的掌握人类免疫缺陷病毒(HIV)合并结核(TB)双重感染患者的结核分枝杆菌的药敏情况,改善防治对策。方法对某院收治的广西地区356例HIV/TB双重感染患者做结核菌的药敏检测,并与3374例单纯结核患者的药敏检测作一对比分析。结果 HIV/TB双重感染患者的耐药率要比单纯HIV的结核患者耐药率低,HIV/TB重感染患者五种抗结核药物的耐药率从高到低依次为利福平(RFP)14.89%、异烟肼(INH)12.64%、乙胺丁醇(EMB)9.60%、链霉素(SM)9.30%、对氨基水杨酸钠(PAS)7.02%,与单纯HIV的结核患者比较([RFP)25.76%、异烟肼(INH)18.40%、乙胺丁醇(EMB)13.19%、链霉素(SM)17.4%、对氨基水杨酸钠(PAS)9.60%],HIV/TB组INH、RFP、SM的耐药率低于对照组,差异有统计学意义(P<0.05),EMB、PAS的耐药率与对照组相比差异无统计学意义(P>0.05)。结论本地区HIV/TB双重感染患者结核分枝杆菌对RFP、INH、SM耐药率及获得性耐药率较单纯结核患者低,对于TB/HIV双重感染者,治疗前重视依从性教育,应在有经验的医务人员的指导下进行治疗,减少耐药性的产生。

Objective To analyze the culture and antibiotic sensitivity of Mycobacterium tuberculosis in pa- tients with human immunodeficieney virus （HIV）/tuberculosis （TB） dual infection, and to improve the prevention and control countermeasures. Methods Drug sensitive test of Mycobacterium tuberculosis was conducted in 356 patients with HIV/TB dual infection （the study group） and 3 374 patients with TB alone （the control group） in Guangxi region. The results were analyzed and compared between the two groups. Results The drug resistance rate of Mycobacterium tuberculosis in the study group was lower than that of the control group. The resistance to rifampiein （RFP）, isoniazid （INH）, ethambutol （EMB）, streptomycin （SM）, amino salicylic acid sodium （PAS） was 14.89%, 12.64%, 9.60%, 9.30%, 7.02% in the study group, and 25.76%, 18.40%, 13.19%, 17.4%, 9.60% in the control group respectively,（P〈 0.05）. The resistance to INH, RFP, SM was significantly lower in the study group, while the resistance to EMB, PAS showed no statistically significant difference between the two groups （P〉0.05）. Conclusion In Guangxi region, with the resistance of Mycobacterium tuberculosis to RFP and INH, SM the acquired resistance in patients with HIV/TB dual infection are lower than those in TB patients, For HIV/TB dual infection, we should attach great importance to the compliance education before treatment and perform treatment under the guidance of experienced medical staff, in or- der to reduce the development of drug resistance.