皮肤和软组织感染非结核分枝杆菌的分布和耐药性分析

Distribution and drug resistance of non-tuberculous mycobacteria in the skin and soft tissue infections

目的分析皮肤和软组织感染患者非结核分枝杆菌的分布特点及耐药性。方法收集2017年2月至2019年2月期间在我院门诊及住院治疗的皮肤和软组织感染患者感染部位分泌物并进行鉴定,分析非结核分枝杆菌的分布;通过药敏试验检测非结核分枝杆菌对5种抗生素的敏感性。结果1152例皮肤与软组织感染患者样本中共检出983株分枝杆菌(85.33%)。其中人型结核分枝杆菌614株(62.46%),牛型结核分枝杆菌307株(31.23%),非结核分枝杆菌62株(6.31%);62株非结核分枝杆菌中包括偶发分枝杆菌18株(29.03%)、龟分枝杆菌8株(12.90%)、溃疡分枝杆菌5株(8.07%)、海分枝杆菌7株(11.29%)、脓肿分枝杆菌10株(16.13%)和快速生长分枝杆菌14株(22.58%);药敏试验结果显示,偶发分枝杆菌、龟分枝杆菌、溃疡分枝杆菌、海分枝杆菌、脓肿分枝杆菌和快速生长分枝杆菌对INH、SM、RFP和PAS的耐药率均在90%以上,对KM的耐药率在80%-95%之间。结论非结核分枝杆菌在皮肤和软组织感染患者中以偶发分枝杆菌、脓肿分枝杆菌和快速生长分枝杆菌最为常见,且非结核分枝杆菌对多种抗生素均有较高的耐药性。

Objective Analysis of distribution and drug resistance of non-tuberculous mycobacteria in patients with skin and soft tissue infections.Methods Collect and identify the infection site secretions of skin and soft tissue infection patients in our hospital outpatient and inpatient treatment from February 2017 to February 2019 and analyze the distribution of non-tuberculous mycobacteria.The drug sensitivity test tested the sensitivity of non-tuberculous mycobacteria to 5 antibiotics.Results A total of 983 mycobacteria were detected in 1,152 patients with skin and soft tissue infections,accounting for 85.33%.Among them,614 were mycobacterium tuberculosis(62.46%),307(31.23%)were mycobacterium bovis,and 62(6.31%)were non-tuberculous mycobacterium.The 62 non-tuberculous mycobacteria include18 strains of mycobacterium forfuifum(29.03%),8 strains of mycobacterium chelone(12.90%),5 strains of mycobacterium ulcerans(8.07%),7 strains of Mycobacterium marinum(11.29)%,10 strains of mycobacterium abscesses(16.13%),and 14 strains of mycobacterium rapid growth(22.58%).Drug susceptibility test results show that the incidence of resistance to INH,SM,RFP,and PAS of NTM above 90%,the resistance rate to KM is between 80%and 95%.Conclusion Non-tuberculous mycobacterium is most common in patients with skin and soft tissue infections in mycobacterium forfuifum,mycobacterium abscessus,and mycobacterium rapid growth.Non-tuberculous mycobacterium has high resistance to a variety of antibiotics.