54例非结核分枝杆菌感染者对二线抗结核药的耐药分析

目的：观察分析非结核分枝杆菌（NTM）的耐药情况。方法收集本院分枝杆菌培养阳性并鉴定为非结核分枝杆菌的病例，并对其药效结果进行分析。结果320例分枝杆菌培养阳性病例中，54例为非结核分枝杆菌，占16.9%，对二线抗结核药物阿米卡星（AK），卷曲霉素（CPM），对氨基水杨酸钠（PAS），莫西沙星（MFX），左氧氟沙星（LFX）和丙硫异烟胺（TH1321）均有不同程度的耐药，耐药率高达87.0%，且大多数呈现多耐药。结论非结核分枝杆菌对抗结核药呈现耐药现象，故临床用药困难，对临床抗结核治疗效果不佳或疑似NTM肺病的患者应及早做痰培养、菌型鉴定及药物敏感试验并寻求其他有效的治疗方法。

Analysis of nontuberculosis Mycobacteria resistance to second-line anti-tuberculosis drug in 54 cases

Objective To evaluate the drug resistance actuality of nontuberculosis Mycobacteria （NTM）. Methods Analysis was carried out on anti-tuberculosis （TB） drug efifcacy in the patients who were conifrmed to be Mycobacterial culture positive but not Mycobacterium tuberculosis cases. Results There were 54 cases of nontuberculosis Mycobacteria among 320 cases of Mycobacteria culture positive cases, accounting for 16.9%, exhibited different degrees of drug tolerance to second-line anti-TB drugs, such as amikacin （AK）, capreomycin （CPM）, sodium para-aminosalicylate （PAS）, moxilfoxacin （MFX）, levolfoxacin （LFX） and protionamide （TH1321）, and most of which presented multidrug resistance. Conclusions Resistance of nontuberculosis Mycobacteria to anti-TB drug leads to the dififculties of clinical application. Sputum culture, bacteria identiifcation, drug sensitive test and other treatments should be adopted for patients with unacceptable clinical anti-TB treatment effects or patients with suspected NTM lung disease.