HIV/AIDS患者合并分枝杆菌感染及耐药性分析

目的了解HIV/AIDS患者合并分枝杆菌感染及其耐药状况。方法对601例HIV/AIDS患者标本用中性改良罗氏（Lowenstein-Jensen）培养基和BacT/ALERT 3D 240全自动培养仪同时进行分枝杆菌培养;培养阳性者用硝基苯甲酸（PNB）培养基、噻吩-2-羧酸肼（TCH）培养基进行菌种初步鉴定和用绝对浓度间接法进行8种抗结核药物敏感性试验。结果分枝杆菌培养阳性116例,检出率为19.30%;其中结核分枝杆菌93株,检出率为15.41%,非结核分枝杆菌23株,检出率为3.89%;93株结核分枝杆菌总耐药率为26.88%,耐多药率（MDR-TB）为7.53%,广泛耐药率（XDR-TB）为1.08%;23株非结核分枝杆菌总耐药率为100%。并且多数呈多重耐药。结论HIV/AIDS患者并发分枝杆菌感染率及其耐药率较高,尤其是非结核分枝杆菌耐药率更高,对HIV/AIDS患者疑为分枝杆菌合并感染时,应对相关标本进行分枝杆菌培养、鉴定和药敏试验,以便指导临床合理用药。

Analysis of HIV/AIDS patients with mycobacterium infection and drug resistance

Objective To understand the conditions of HIV/AIDS patients with mycobacterium infection and drug resistance.Methods Various specimens collected from 601 HIV/AIDS patients were cultured for detection of mycobacterium by neutral Lowenstein-Jensen culture medium and BacT/ALERT 3D 240 automatic culture system.If culture positive,strains preliminary identified were taken by nitrobenzoic acid（PNB） culture medium and thiophene-2-carboxylic acid hydrazide（TCH） culture medium,and then we took 8 kind of anti-tuberculosis drug susceptibility testing by indirect method of absolute concentration.Results Mycobacteria were detected from 116 cases with a positive rate of 19.30%.,including 93.Mycobacterium tuberculosis strains（15.41%）23 non-Mycobacterium tuberculous strains（3.89%）.The general drug resistant rate,multi-resistant rate and extensive drug resistant rate of 93 Mycobacterium tuberculosis strains were 26.88%,7.53% and 1.08%.The total drug resistance of 23 non-mycobacteriium tuberculous strains was 100%,and most were multidrug resistant.Conclusion The co-infection of HIV/AIDS patients with mycobacterium drug resistant rate are higher,especially in those with non-tuberculous mycobacterium.Culture,idenfication and drug sensitivity test of mycobacterium be conducted in case the HIV/AIDS cases were suspected to be co-infected with mycobacterium.