绍兴地区分枝杆菌感染情况及耐药性分析

Analysis of infection and drug resistance of Mycobacteria in Shaoxing area

目的了解本地区分枝杆菌的感染情况,并对菌种、耐药情况及患者常见临床特征进行分析。方法收集2022年1月—9月本地区分枝杆菌感染患者标本及相关临床资料,采用MGIT液体培养法进行菌株培养,基因芯片进行菌种鉴定,微量肉汤稀释法进行体外药敏试验。结果共确诊并分离得到分枝杆菌322株,包括229株结核分枝杆菌(Mycobacterium tuberculosis,MTB)和93株非结核分枝杆菌(nontuberculous mycobacteria,NTM);其中耐多药结核分枝杆菌(multidrug-resistant Mycobacterium tuberculosis,MDR-TB)为13株,预泛耐药结核分枝杆菌(pre-extensively drug-resistant Tuberculosis,pre-XDR TB)为5株,泛耐药结核分枝杆菌(extensively drug-resistant Tuberculosis,XDR-TB)为1株。NTM以龟/脓肿分枝杆菌的耐药率较高。NTM感染患者伴有基础疾病的比例较高,以肺部基础疾病常见(P<0.01)。结论分枝杆菌感染患者大部分为MTB感染,对一线药物的耐药率高于二线药物,而NTM感染主要由缓慢生长型NTM引起,且伴有基础疾病的比例较高,两类患者在临床表现上难以区分,因此快速的菌种鉴定及药敏结果有助于临床的早期诊断及治疗。

Objective This paper aims to investigate the infection of Mycobacteria in Shaoxing area and analyze its types,drug resistance,and the common clinical features.Methods Specimens and clinical information of patients from January 2022 to September 2022 were collected and analyzed.Specimens were cultured by MGIT liquid culture method.Gene chip was used for bacterial species identification,and micro-broth dilution method was used for drug susceptibility test in vitro.Results A total of 322 Mycobacterium strains were detected and collected,including 229 strains of Mycobacterium tuberculosis(MTB)and 93 strains of Non-tuberculous Mycobacteria(NTM).There are 13 strains of multidrug-resistant Mycobacterium tuberculosis(MDR-TB),5 strains of pre-drug-resistant Tuberculosis(pre-XDR TB),and 1 strain of extensively drug-resistant Tuberculosis(XDR-TB).The drug resistance rate of NTM with Mycobacterium chelonis/abscess was higher.The proportion of NTM patients with underlying diseases was high,and the underlying diseases of lung were common(P<0.01).Conclusion Most of the patients with mycobacterial infection were MTB infection,and the drug resistance rate to first-line drugs was higher than that of second-line drugs,while NTM infection was mostly caused by slow-growing NTM.The propor⁃tion of underlying diseases of NTM patients was higher than that of MTB patients.Two types of patients were difficult to distin⁃guish in clinical manifestations,so rapid bacterial species identification and drug susceptibility tests were helpful for clinical diagnosis and treatment early.