河南省尉氏县结核病的病原学调查及结核分枝杆菌耐药性分析

目的 调查河南省结核病的分枝杆菌菌种类型、分布特征及耐药状况。 方法 对研究现场所有疑似结核病患者进行痰涂片和痰菌培养;用鉴别培养基和双重聚合酶链反应(PCR)方法对分离的菌株进行菌种鉴定,用比例法进行药物敏感性检测。 结果 共收集患者2661份痰标本,应用痰涂片、痰培养和双重PCR三种方法联合应用进行病原学分析,发现涂片阳性者179份(占6.5%);培养阳性菌株245份,阳性率为9.2%,其中225株为结核分枝杆菌,占91.8%,结核分枝杆菌复合群6株,占2.4%,13株为非结核分枝杆菌(NTM),占5.3%,1株为结核分枝杆菌与非结核分枝杆菌混合感染,占0.4%。药敏检测显示结核分枝杆菌总体耐药率为24.0%(54/225),4种药物的耐药率链霉素16.9%(38/225),异烟肼 16.0%(36/225),利福平 9.8%(22/225),乙胺丁醇8.4%(19/225)。耐单药菌株20株,占8.9% ,耐2种药以上的多药耐药为15.1%(34/225),其中,同时耐异烟肼和利福平及2种以上抗生素菌株即耐多药株(MDR-TB)菌株19株,占8.4%(19/225)%。男、女性结核病患者耐药率差异无统计学意义(2=2.8214,P0.05),耐药与年龄的相关性差异有统计学意义(2=8.3868,P0.05),复治病例耐药率与初治病例耐药率差异有统计学意义(2=13.7193,P0.05);复治病例MDR-TB耐药率与初治病例MDR-TB耐药率差异有统计学意义(211.1361,P0.05)。 结论 河南省尉氏县的结核病病原菌包括结核分枝杆菌、结核分枝杆菌复合群及非结核分枝杆菌,耐药情况较为严重,尤其对复治病例、较年轻病例应引起重视。

Survey on etiology of tuberculosis and drug-resistance of Mycobacterium tuberculosis in Weishi county,Henan province

Objective To investigate bacteriological prevalence situation of tuberculosis(TB)and the situation of drug resistant in Weishi,Henan.Methods The isolate strains were identified by the identification culture and multiplex polymerase chain reaction(PCR).The strains were tested drug resistant with proportion method.Results Total 2661 sputum samples were detected.179 cases were sputum smear positive(6.5%),245 cases were culture positive(9.2%),Among them,225 strains were Mycobacterium tuberculosis(MTB.Mycobacter...