分支杆菌139例耐药情况分析

目的通过分析139例分支杆菌培养及药敏资料,探讨分支杆菌耐药情况。方法收集2011年5月20日～2012年7月31日我院结核病区139例结核病患者痰结核培养及药物敏感(包括异烟肼、利福平、链霉素、乙胺丁醇、左氧氟沙星、卡那霉素,对氨基水杨酸7种抗结核药物)试验数据,分析其耐药情况。结果对7种药物全敏感43例(30.9%,43/139),耐药96例(69.1%,96/139)。单耐药24例(17.3%,24/139),多耐药27例(19.4%,27/139),耐多药(MDR)45例(32.4%,45/139),广泛耐药(XDR)10例(7.2%,10/139)。耐药率:INH(47.48%)>PAS(46.04%)>RFP(38.13%)>S(26.62%)>Km(20.14%)>Lfx(19.42%)>EMB(16.55%)。对一线药品均敏感57例(41%,57/139),对一线药品均耐药82例(59%,82/139)。对二线药品均敏感62例(44.6%,62/139),对二线药品均耐药77例(55.4%,77/139)。结论分支杆菌感染耐药情况严重,应重视及加强分支杆菌培养分析,根据药敏及时调整,减少无效治疗。

Analysis of 139 cases of drug resistance of mycobacterium

Objective To analyze 139 cases of mycobacterial culture and drug susceptibility, and explore the drug resist-ance of mycobacterium. Methods Sputum tuberculosis culture and drug susceptibility （ from7 antituberculosis drugs, inclu- ding isoniazid, rifampicin, streptomycin, ethambutol, levofloxaein, kanamycin, and aminosalicylie acid ） from 139 cases of pa-tients between May 20, 2011 and July 31,2012 were collected and analyzed. Results 43 cases were totally sensitive （30. 9% ,43/139 ）. Drug resistance occurred in 96 cases （69.1% ,96/139 ） ,single drug resistance in 24 cases（ 17.3% ,24/ 139） ,multiple drug resistance in 27 cases（ 19.4% ,27 / 139） ,multidrug resistance （MDR） in 45 patients （32.4% ,45/139 ） ,and extensively drug-resistance in 10 cases （XDR） （7.2% , 10/139 ）. Resistance rates showed INH （47.48% ） 〉 PAS （46.04%） 〉 RFP （38.13%） 〉 S （26.62%） 〉 Km （20. 14%） 〉 Lfx （19.42%） 〉 EMB （16.55%）. 57 cases （ 41% , 57/139 ）were sensitive to first-line drugs;82 cases （ 59% , 82/139 ） were resistant to first-line drugs. On the other hand ,62 cases （ 44.6% ,62/139 ） were sensitive to the second-line drugs ;77 cases （ 55.4% ,77/139 ） were resistant to the sec-ond line drugs. Conclusion Situation of drug resistance is serious in cases of mycobacterial infections. Importance of myco-bacterium cuhure should be addressed and drug susceptibility should be timely adjusted to reduce the ineffective treatment.