江苏省60株非结核分枝杆菌的耐药性分析

Drug resistance analysis of 60 Nontuberculous mycobacteria isolated strains in Jiangsu province

目的分析江苏省非结核分枝杆菌(NTM)的耐药水平和流行病学特点,为制定有效的防控措施提供科学依据。方法采用比例法,对2008年全省结核病耐药基线调查中确诊的60株NTM,进行针对异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)和硫酸链霉素(SM)的药敏实验。结果 60株NTM的耐药率为98.33%,耐INH+RFP率为65.00%。对RFP、INH、SM等3种药物同时耐药的5株(占8.33%),对4种药物同时耐药的34株(占56.67%)。初治组耐药率、耐INH+RFP率(95.65%、43.48%)均低于复治组(100.00%、78.38%),差异均具有统计学意义(P值均<0.05)。结论江苏省NTM耐药率、耐INH+RFP率水平较高,复治患者是耐药的主要群体,应作为NTM感染防控的重点人群。

Objective To describe drug resistance spectrum of Nontuberculous rnycobacteria （NTM） in J iangsu province;to provide scientific evidence to making effective prevention and control measures to NTM. Methods Proportional method was used to determine the drug resistance of NTM to 4 kind of first-line anti-tuberculosis drugs including isoniazid（INH） ,rifampin （RFP） ,ethambutol（EMB） and streptomycin（SM）. Results Drug resistance rate of 60 NTM strains was 98.33 %, dual drug resistance to INH ＆ RFP rate was 65.00 %. A total of 5 strains were simultaneously resistant to RFP, INH, SM （accounting for 8.33%）;while 34 strains were simultaneously resistant to 4 drugs （accounting for 56.67 %）. The drug resistance rate and dual drug resistance to INH ＆ RFP rate （95.65%, 43.48%, respectively） in initial treatment group were both lower than those in the retreatment group （100.00%, 78.38% ,respectively）, the differences were statistically significant （all P〈0. 05）. Conclusion The drug resistance rate and dual drug resistance to INH ＆ RFP rate of NTM in Jiangsu province were relatively high. Retreated patients were major drug resistant population, who should be focused as primary targets for future infection prevention.