106例复治痰涂片阳性肺结核患者的痰培养及耐药性分析

Sputum culture and drug resistance analysis of 106 pulmonary tuberculosis patients with smear positive

目的收集天津市结核病控制中心首次治疗失败的结核病患者的耐药情况,为复发患者制定合理化方案提供参考。方法纳入者从2010年1月-2014年12月选取有痰培养阳性结果以及药物敏感性试验结果的患者。所有纳入患者的痰培养结果分别进行6种抗结核药物敏感性检测。结果 106例复治痰涂片阳性肺结核患者中出现18例痰培养阴性,其余88例痰培养阳性中,出现耐药情况55例,耐药者占51.89%,单耐药率为17.05%,多耐药率为5.68%,耐多药率为14.77%,耐多药以耐3种～4种药物的患者较多,共11例,占全部耐多药患者的84.62%。结论复治痰涂片阳性的肺结核患者耐药率及耐多药率较高,且耐多药中耐3种以上药物居多,应重视广泛耐药情况的发生。当前的标准化复治肺结核方案患者应及时关注痰培养及药敏试验结果,以指导下一步治疗。

Objective To access the drug resistance in patients with the first failure treatment of tuberculosis in Tianjin Municipal Center for Tuberculosis Control,so as to provide reference for establishing rational treatment of recurrent tuberculosis.Methods Patients with positive sputum culture and drug resistance test were collected during Jan 2010- Dec 2014. Sputum culture results of all the patients were performed for 6 kinds of anti TB drug＇sensitivity tests. Results 106 cases of patients with smear positive pulmonary tuberculosis occurred with 18 cases of negative sputum culture,and 55 cases were drug- resistant in the remaining 88 cases of positive sputum culture,with the total resistance rate of 51. 89%. The mono resistant rate was17. 5%,the poly- resistant rate was 5. 68%,and the multi- drugresistant rate was 14. 77%,and its resistance to more than 3or 4 kinds of drugs were in 11 cases,accounting for 84. 62%. Conclusion The drug resistance and multi- drug resistance of the patients with recurrent treatment of pulmonary tuberculosis is high,but the multi drug resistance to 3 or more drugs is dominant,more attention should be paid to the widespread drug resistance. The current standard treatment for tuberculosis patients should be paid attention to the results of sputum culture and drug sensitivity test in order to guide the next treatment.