镇江市结核分枝杆菌药敏试验结果分析

Analysis of drug susceptibility test results of mycobacterium tuberculosis in Zhenjiang city

目的了解镇江市结核病患者的耐药情况,为结核病的防制提供依据。方法按照《结核病诊断实验室检验规程》进行分离培养,菌种鉴定,采用比例法进行药敏试验。结果分离的712株分枝杆菌中结核分枝杆菌680株(95.5%);非结核分枝杆菌(NTM)32株(4.5%)。680株结核分枝杆菌总耐药率31.9%,初治耐药率17.3%,复治耐药率56.7%;初治耐药菌株占耐药菌株的34.1%;总耐多药(MDR)率为18.7%,复治耐多药率(42.9%)显著高于初治耐多药率(4.4%)。结论结核病人进行痰培养并将分离出的分枝杆菌进行菌种鉴定对NTM与结核病的鉴别诊断、治疗有重要意义。研究表明过去几年镇江市在结核病的管理和治疗上有待改善,应加强结核病人的归口管理,慎重制定治疗方案,减少耐药菌株的产生。

Objective To understand the drug resistance situation of TB patients in Zhenjiang city, in order to provide the basis for rib control and prevention. Methods Mycobacterium tuberculosis strains were isolated, cultured and identified in accordance with the ＂Laboratory testing procedures for TB diagnosis＂, and the susceptibility testing was conducted using the proportional method. Results There were 680 mycobacterium tuberculosis strains in 712 isolates （95.5%）, and the other 32 isolates were non -tuberculous mycobacteria （NTM） （4.5 % ）. In 680 mycobacterium tuberculosis isolates, the total drug resistance rate was 31.9%, the initial treatment resistance rate was 17.3%, and re - treatment resistance rate was 56.7% ; Drug - resistant strains accounted for 34.1% of drug - resistant strains in initial treatment; total MDR rate was 18.7%, re - treatment MDR rate （42.9%） was significantly higher than that of initial treatment （4.4%）. Conclusion It is very important for the differential diagnosis and treatment of NTM and TM by culturing TB sputum and identifying mycobacteria isolates. Studies show that the management and treatment of tuberculosis over the past few years need improvement in Zhenjiang. Furthermore, the centralized management of TB patients and careful treatment programs selection should be strengthened to reduce drug - resistant strains.