抗酸菌耐药结果分析

摘要：目的统计分析评价内蒙古自治区第四医院1997年1月到2021年4月抗酸杆菌阳性菌株耐药情况。方法采用抗酸菌培养加菌型鉴定加药敏试验的方法、基因芯片耐药检测方法、BACTEC MGIT960System960抗酸菌耐药检测方法对抗结核药物异烟肼、利福平、乙胺丁醇、吡嗪酰胺、丙硫异烟胺，左氧氟沙星、氧氟沙星对氨基水杨酸钠、丙硫异胺、卷曲霉素做药物敏感性检测。结果 1612例抗酸菌培养加药敏，其中共检出22例非结核分支杆菌。耐药检测耐药率由高到低分别是异烟肼26.7%>利福平17.3%>链霉素14.6%>乙胺丁醇11.9%>氧氟沙星11.8%>丙硫异烟胺11.5%>耐多药为7.9%>广泛耐药为5.9%>阿米卡星3.1%>卷曲霉素2.4%>对氨基水杨酸钠0.2%; BACTEC MGIT960System 960培养阳性菌株21株，吡嗪酰胺耐药3株，耐药率为1.4%。结论 1 从2017年到2021年，抗酸菌耐药结果显示利福平耐药由历年最低13.3%上升到目前的21%，耐多药由最低0.4%上升到15.3%，氟喹诺酮类氧氟沙星药物抗结核耐药率由0.9%上升到目前26.1%，我院是自治区级治疗结核病的专科医院，一定程度上代表着我区的结核病耐药现状，提示我们结核病控制的复杂性和新的变化。2 耐多药和广泛耐药结核病的存在提示我们要重视结核病的规范治疗，随时评价治疗效果，制定合理有效的抗结核治疗方案。3氟喹诺酮类氧氟沙星药物抗结核耐药率由0.9%上升到目前26.1%，不能除外患者在确诊结核之前应用该类抗生素比率高有关。

Analysis of the results of drug resistance of acid-fast bacilli

Abstract: Objective To analyze and evaluate the drug resistance of positive strains of acid-fast bacilli from January 1997 to April 2021 in the Fourth Hospital of Inner Mongolia Autonomous Region. Methods Using acid-fast bacteria culture and bacteria type identification plus drug sensitivity test method, gene chip drug resistance detection method, BACTEC MGIT960System960 acid-fast bacteria drug resistance detection method anti-tuberculosis drugs isoniazid, rifampicin, ethambutol, Pyrazinamide, prothionamide, levofloxacin, ofloxacin are tested for drug sensitivity to sodium aminosalicylate, prothionamide, capreomycin. Results 1612cases of acid-fast bacteria were cultured and drug-sensitive, and 5 cases of non-tuberculous mycobacteria were detected. The resistance rate of drug resistance detection from high to low was 30.6% for prothio-isonicotinamide, 26.7% for Rm, 17.3% for R, 14.6% for Sm, and 7.9% for multidrug resistance. The drug was 0.8%, which was the highest rate among men over 60 years old. 21 strains were cultured positive in 960, and 3 strains were resistant to pyrazinamide. The drug resistance rate was 1.4%. Conclusion 1 Prothionamide has a high drug resistance rate among patients admitted to our hospital, which suggests that our hospital should fully consider this factor in the formulation of future anti-tuberculosis treatment programs. 2 The existence of multidrug-resistant and extensively drug-resistant tuberculosis prompts us to attach importance to the standardized treatment of tuberculosis, evaluate the treatment effect at any time, and formulate a reasonable and effective anti-tuberculosis treatment plan.