2013—2015年西安市胸科医院结核分枝杆菌的耐药性分析

Analysis on drug resistance of Mycobacterium tuberculosis in Xi'an Chest Hospital from 2013 to 2015

目的了解西安市胸科医院结核分枝杆菌的耐药情况,为临床医生调整治疗方案和流行病学调查提供依据。方法选取2013年1月—2015年11月西安市胸科医院结核分枝杆菌感染的住院患者392例,对分离出的病原菌的耐药性进行分析。结果菌株来源于132例初治患者和260例复治患者,其中男性患者多于女性患者,年龄段主要集中在36~55岁。初治耐药率为22.5%,获得性耐药率为41.2%;链霉素的耐药率最高,为23.7%,乙胺丁醇的耐药率最低,为13.3%;单一耐药菌株有60株,耐药率为15.4%;多耐药菌株有37株,耐药率为9.4%;耐多药的菌株有52株,耐药率为13.2%;有27株全耐药,耐药率为6.9%。结论西安市胸科医院结核分枝杆菌的耐药状况仍处较高水平,应做好结核分枝杆菌的培养和药敏试验,并根据药敏实验结果合理制定或调整治疗方案。

Objective To investigate the drug resistance of Mycobacterium tuberculosis in Xi＇an Chest Hospital, and to provide reference for clinicians to adjust the therapeutic schedule, and epidemiological investigation. Methods Inpatients（392 cases） with hospital acquired infection in Xi＇an Chest Hospital from January 2013 to November 2015 were selected. The drug resistance of pathogenic bacteria was analyzed. Results Strains were obtained from initial patients（132 cases） and retreated patients（260 cases）. In which male patients were more than female patients, and the ages of most patients were 36 to 55 years old. Initial drug resistant rate was 22.5%, and acquired resistance was 41.2%. The drug resistant rate of streptomycin was the highest, taking for 23.7%. While the drug resistant rate of ethambutol was the lowest, accounting for the percentages of 13.3%. There were 60, 37, 52, and 27 strains of single drug resistant strains, multiple drug resistant strains, multi-drug resistant strains, and all the drug-resistant strains. And the percentage was 15.4%, 9.4%, 13.2%, and 6.9%, respectively. Conclusion The drug resistance of M. tuberculosis in Xi＇an Chest Hospital is still at a higher level, the cultivation of M. tuberculosis and drug susceptibility test should be well done, and the therapeutic schedule should be set reasonably or adjusted according to the results of drug sensitive experiment.