100例疑似肺结核患者呼吸道标本中分枝杆菌分离鉴定及药敏性分析

Isolation,Identification and Drug Sensitivity Analysis of Mycobacteria in Respiratory Tract Samples from 100 Patients with Suspected Pulmonary Tuberculosis

目的 分析100例疑似肺结核患者呼吸道标本中分枝杆菌分离鉴定及药敏性。方法 对2021年1月至2023年10月西湖区疾病预防控制中心收治的100例疑似肺结核患者的呼吸道标本进行病菌培养分离及药敏实验,分析分枝杆菌的鉴定结果和耐药性。结果 100例疑似肺结核患者共确诊24例肺结核病例,检出分枝杆菌96株,其中非结核分枝杆菌共72株(75.00%),结核分枝杆菌共24株(25.00%)。非结核分枝杆菌主要以胞内分枝杆菌和脓肿分枝杆菌为主,分别为27株(28.13%)和19株(19.79%)。96例分枝杆菌中,痰液标本共检出49株,肺泡灌洗液标本共检出47株。痰液标本中主要分枝杆菌为胞内分枝杆菌和脓肿分枝杆菌,分别为15株(30.61%)和10株(20.41%);肺泡灌洗液标本中主要分枝杆菌为结核分枝杆菌和胞内分枝杆菌,分别为15株(31.91%)和12株(25.53%)。胞内分枝杆菌对异烟肼、利福平和氧氟沙星的耐药性较高,耐药率分别为70.37%、62.96%和59.26%。脓肿分枝杆菌对卷曲霉素和氧氟沙星的耐药性较高,耐药率分别为89.47%和84.21%。结核分枝杆菌对链霉素、利福平和乙胺丁醇的耐药性较高,耐药率分别为33.33%、29.17%和25.00%。结论 100例疑似肺结核患者呼吸道标本中非结核分枝杆菌的占比较高,且对常规抗结核药物的耐药性强,临床治疗时应根据分枝杆菌的耐药性合理用药,保证药物的治疗有效性。

Objective To analyze the isolation,identification and drug sensitivity of mycobacteria in respiratory tract samples from 100 patients with suspected pulmonary tuberculosis.Methods The culture,isolation and drug sensitivity test of pathogens in respiratory tract samples were performed in the 100 patients with suspected pulmonary tuberculosis admitted to Xihu District Center for Disease Control and Prevention between January 2021 and October 2023.The identification results and drug resistance of mycobacteria were analyzed.Results In the 100 patients with suspected pulmonary tuberculosis,there were 24 confirmed cases.In the 96 strains of mycobacteria,there were 72 strains of non-tuberculosis mycobacteria and 24 strains of tuberculosis mycobacteria.The main non-tuberculous mycobacteria were mycobacterium intracellulare and mycobacterium abscessus[27 strains(28.13%),19 strains(19.79%)].Among In the 96 strains of mycobacteria,there were 49 strains from sputum samples and 47 strains from alveolar lavage fluid samples.In sputum samples,main mycobacteria were mycobacterium intracellulare and mycobacterium abscessus[15 strains(30.61%),10 strains(20.41%)].In alveolar lavage fluid samples,main mycobacteria were tuberculous mycobacteria and mycobacterium intracellulare[15 strains(31.91%),12 strains(25.53%)].The drug resistance rates of mycobacterium intracellulare were high to isoniazid,rifampicin and ofloxacin(70.37%,62.96%,59.26%),drug resistance rates of mycobacterium abscessus were high to capreomycin and ofloxacin(89.47%,84.21%),and drug resistance rate of tuberculous mycobacteria were high to streptomycin,rifampin and ethambutol(33.33%,29.17%,25.00%).Conclusion The proportion of non-tuberculosis mycobacteria in respiratory tract samples is relatively high in the 100 patients with suspected pulmonary tuberculosis,and the drug resistance was high to routine anti-tuberculosis drugs.In clinical treatment,rational medication should be taken based on the drug resistance of mycobacteria to ensure the effectiveness of drug treatment.