589株结核分枝杆菌对10种药物的耐药性分析

目的了解深圳市第三人民医院结核病患者结核分枝杆菌对10种药物的耐药情况。方法用MB/Bact 240分枝杆菌培养仪和改良罗氏管对患者的多种标本进行分枝杆菌分离培养鉴定,对分离到的结核分枝杆菌采用绝对浓度法对10种抗结核药物,利福平（RFP）、异烟肼（INH）、乙胺丁醇（EMB）、链霉素（SM）,利福喷丁（RFT）、丙硫异烟肼（TH）、氧氟沙星（OFL）、卷曲霉素（CPM）、卡那霉素（KM）和对氨基水扬酸（PAS）进行药敏试验。结果 1722例患者的标本结核分枝杆菌培养阳性589株,阳性率为34.2%（589/1722）,589株结核分枝杆菌对10种药总耐药率38%（224/589）,单耐药率最高为SM（17.1%）,最低为PAS（3.4%）;55株MDR-TB对另外8种药物耐药率最高为RFT（94.5%）,最低为KM（20%）和PAS（20%）,对10种药物全耐者有3株（0.5%）。结论结核菌耐药情况仍然十分严重,应加强抗结核药物的耐药性监测;根据药敏试验结果选择科学有效的化疗方案。

Analysis of drug resistance of 589 Mycobacterium Tuberculosis strains for 10 type antituberculosis drugs

Objective To analyze the drug resistance of Mycobacterium Tuberculosis（M.TB） for 10 type antituberculosis drugs in Shenzhen Third People′s Hospital.MethodsAll kinds of samples were cultured with MB/Bact 240 and improved L-J medium,clinical isolated M.TB strains were tested with absolute concentration method for 10 type antituberculosis drugs,including RFP、INH、EMB、SM、RFT、TH、OFL、CPM、KM and PAS.Results589 strains M.TB were isolated in 1722 samples,the positive rate of M.TB is 34.2%（589/1722）,the total ratio of drug resistant for 10 type antituberculosis drugs is 38%（224/589）;Of 10 type antituberculosis drugs,the highest resistant rate is SM（17.1%）,the lowest is PAS（3.4%）.Of 55 strains multidrug resistant tuberculosis（MDR-TB）,the highest resistant rate is RFT（94.5%）,the lowest is KM（3.4%） and PAS（3.4%）,3 strains MDR-TB are resistant to another 8 type antituberculosis drugs.ConclusionsClinical isolated M.TB of Shenzhen area is very serious on drug resistant.Monitoring of resistance to antituberculosis drugs must be strengthened;Choosing reasonable and efficient therapy on guideline of antituberculosis susceptibility test.