非结核分枝杆菌肺病的菌种分布及耐药性分析

Distribution and Drug Resistance Analysis of Non tuberculosis Mycobacterium in Pulmonary Disease

目的 探讨非结核分枝杆菌肺病的菌种分布及药敏试验结果,为非结核分枝杆菌肺病的诊疗提供依据。方法 以山东省胸科医院2018年1月至2020年9月确诊的非结核分枝杆菌肺病患者143例患者为研究对象,其中男性87例,平均年龄(56.28±15.53)岁,女性56例,平均年龄(51.88±17.50)岁,收集患者的菌型鉴定结果及药物敏感试验结果进行分析。结果 143株肺结核分枝杆菌菌株中,9类NTM亚种被分离,胞内分枝杆菌(54.55%)最常见,其次为脓肿分枝杆菌(20.97%),其他相对少见。药敏试验结果显示:非结核分枝杆菌耐药率高,耐药依次为亚胺培南、复方新诺明、多西环素、米诺环素、乙胺丁醇、妥布霉素、加替沙星、头孢西丁、利福平、利福布汀、阿奇霉素、克拉霉素、阿米卡星、莫西沙星、利奈唑胺。结论 非结核分支杆菌肺病菌种类型复杂多样,且耐药情况严重,应对可疑患者尽早行菌型鉴定及药物敏感性测定。

Objective To investigate the strain distribution of non-tuberculous mycobacterial pulmonary disease and the results of drug susceptibility test,so as to provide a basis for the diagnosis and treatment of non-tuberculous mycobacterial pulmonary disease.Methods A total of 143 patients with nontuberculous mycobacterial lung disease diagnosed from January 2018 to September 2020 in Shandong Provincial Chest Hospital were selected as the research subjects,including 87 males,with an average age of(56.28±15.53) years old,and 56 females.The average age was(51.88±17.50) years old,and the results of bacterial type identification and drug sensitivity test results of patients were collected for analysis.Results Among the 143 strains of Mycobacterium tuberculosis,9 types of NTM subspecies were isolated.Mycobacterium intracellulare(54.55%) was the most common,followed by Mycobacterium abscessus(20.97%),and the others were relatively rare.The results of the drug susceptibility test showed that the drug resistance rate of non-tuberculous mycobacteria was high,and the drug resistance was imipenem,compound trimethoprim,doxycycline,minocycline,ethambutol,tobramycin,Gatifloxacin,Cefoxitin,Rifampicin,Rifabutin,Azithromycin,Clarithromycin,Amikacin,Moxifloxacin,Linezolid.Conclusion The types of nontuberculous mycobacterial lung disease are complex and diverse,and the drug resistance situation is serious,and suspicious patients should be identified as soon as possible for bacterial type identification and drug susceptibility testing.