非结核分枝杆菌耐药情况分析

目的探讨非结核分枝杆菌(non-tuberculosis mycobacterium,以下简称NTM)的流行病学特征,观察和分析NTM的耐药情况,为NTM肺病的防治策略提供科学依据。方法对2006～2010年期间收集的分枝杆菌进行药物敏感性测定、菌种鉴定,对鉴定为NTM的病例进行综合分析。结果 5年间对765个菌株进行了结核分枝杆菌和非结核分枝杆菌的菌型鉴,确诊为NTM的为79株(10.32%),其中77株对异烟肼、对氨基水杨酸钠、乙胺丁醇、利福平、链霉素等常用抗结核药物存在不同程度的耐药,耐药率高达97.46%,且大多菌株同时对多种抗结核药物耐药。结论 NTM对抗结核药物具极高的耐药性。为此,对可疑肺结核患者应尽可能进行痰分离培养和多种抗结核药物敏感性测定。研究、探索抗NTM的新药及更为有效的诊断方法是当务之急。

Analysis on drug resistance of non-tuberculosis mycobacterium in Sichuan province

Objective To discuss the epidemiology character of non-tuberculosis mycobacterium(hereinafter referred to as NTM),analyze drug resistance and provide scientific evidence for the NTM control strategies.Methods The positive mycobacteriums collected from 2006 to 2010 were detected by tests of drug susceptibility and strain identification,and we analyzed the cases with NTM.Results 765 strains of positive mycobacterium were separated into tuberculosis mycobacterium composite group and non-tuberculosis mycobacterium,79 strains were identified as NTM,10.32% of total strains;77 strains had drug resistance with varying degrees to isoniazid,paminosalicylic acid,ethambutol,rifampicin,streptomycin.The rate of drug resistance was 97.46%,and most of the strains had drug resistance to various antituberculosis drugs.Conclusion NTM have strong drug resistance to antituberculosis drugs.So we need to conduct isolation and culture of the sputum of the suspicious patients with Tuberculosis,and detect drug susceptibility of the various antituberculosis drugs,to research new drugs against NTM and explore the more effective diagnosis methods.