新疆喀什地区214株结核分枝杆菌耐药情况及菌型分析

目的 分析新疆喀什地区结核分枝杆菌临床分离株对8种抗结核药物的耐药情况，探讨本地区耐药结核病和菌型流行情况。 方法 收集2010年6月1日至2010年12月31日新疆喀什地区结核病防治所确诊的214例结核病患者痰标本，对分离培养的214株分枝杆菌采用比例法进行药物敏感（包括异烟肼、利福平、链霉素、乙胺丁醇、氧氟沙星、卷曲霉素、卡那霉素、阿米卡星8种抗结核药物）和菌型鉴定试验，计数资料组间比较采用χ²检验，P＜0.05为差异有统计学意义。 结果 214株分离株中175例（81.78%）为人结核分枝杆菌，39例（18.22%）为牛结核分枝杆菌，人结核分枝杆菌耐药率（29.14%，51/175）与牛结核分枝杆菌耐药率（12.82%，5/39）差异有统计学意义（χ²=4.398，P=0.034），人结核分枝杆菌耐多药率（5.71%，10/175）与牛结核分枝杆菌耐多药率（0%）相比，差异无统计学意义(χ²=1.231，P=0.267)；患者总耐药率为26.17%（56/214），初治患者耐药率25.97%（20/77），复治患者耐药率26.28%（36/137），两者差异无统计学意义（χ²=0.0003，P=1.00）。8种耐任一抗结核药物耐药率占前四位的分别为：异烟肼、链霉素、利福平、乙胺丁醇。 结论 新疆喀什地区结核病患者耐药情况仍较严重，分型以人结核分枝杆菌为主，在结核病治疗工作中应给予高度重视。

Analysis of drug resistances and strain types in 214 Mycobacterium tuberculosisisolates in Kashi region,Xinjiang

Objective To analyze drug resistances to 8 kinds of anti-TB drugs and strain types in Mycobacterium tuberculosis clinical isolates in Kashi region,Xinjiang.Methods 214 mycobacterial strains were cultured and isolated from sputum specimen from December 31,2010,to June 1,2010.and then identified their strain types and drug resistances to 8 kinds of anti-TB drugs,including isoniazid,rifampicin,streptomycin,ethambutol,ofloxacin,capreomycin,kanamycin,amikacin,by the proportional method for drug susceptibility testing.The count data between the two groups were compared using the χ2 test,P<0.05 was considered as statistically significant difference.Results Of 214 isolates,175(81.78%) were Mycobacterium tuberculosis,39(18.22%) were Mycobacterium bovis.The drug-resistant rates had the statistical difference between Mycobacterium tuberculosis(29.14%,51/175)and Mycobacterium bovis(12.82%,5/39)(χ2=4.398,P=0.034).The total drug-resistant rate was 26.17%,initial drug-resistant rate was 25.97%(20/77),and acquired drug-resistant rate was 26.28%(36/137).They had not statistical difference(χ2=0.0003,P=1.00).The rates of resistance to 8 kinds of anti-TB drugs accounting for the top four were as follows: isoniazid,streptomycin,rifampicin,ethambutol.Conclusion The situation of drug resis-tance in TB patients is severe in Kashi region,Xinjiang.The infection of Mycobacterium tuberculosis is dominant.