非结核分枝杆菌的耐药性分析及临床意义

Drug resistance analysis and clinical significance of nontuberculosis Mycobacterium

目的分析非结核分枝杆菌的感染、耐药情况,为临床合理用药提供科学依据。方法采用快速全自动分枝杆菌培养/药敏检测系统(Bactec MGITsyste)检测标本,阳性标本采用VITEK MS质谱分析仪鉴定。结果2016年-2018年3年共检出非结核分枝杆菌157株,主要来自ICU、呼吸内科、神经内科、血液科,分别占31.2%、22.3%、13.4%、13.4%,居前三位的分别为胞内分枝杆菌、鸟分枝杆菌、脓肿分枝杆菌,对常用的抗结核药物敏感性较低,克拉霉素敏感性较好。结论NTM感染应尽早鉴定菌株并根据药敏结果合理选用抗菌药物,避免更多耐药菌株出现。

Objective To analyze the infection and drug resistance of nontuberculosis Mycobacterium and provide scientific basis for clinical drug use.Methods A rapid automatic Mycobacterium culture/drug sensitivity detection system(Bactec MGITsyst)was used to detect the specimens,and the positive specimens were identified by VITEK MS mass spectrometry analyzer.Results A total of 157 nontuberculous Mycobacterium strains were detected in 2016-2018,mainly from ICU,respiratory medicine,neurology,and hematology,accounting for 31.2%,22.3%,13.4%,and 13.4%respectively,and the top three were intracellular Mycobacterium,avian Mycobacterium and abscess Mycobacterium.The sensitivity to commonly used anti-tuberculosis drugs was low,and that of clabomycin was better.Conclusion NTM infection should be identified as early as possible and antibacterial drugs should be reasonably selected according to the drug sensitivity results to avoid more resistant strains.