論著(zhù)
西藏自治區非結核分枝桿菌耐藥特點(diǎn)及臨床特征初步分析
黃麗萍1 石荔1* 魏淑貞2 巴桑1 西洛1
【摘要】 目的 探討西藏自治區非結核分枝桿菌（NTM）的耐藥情況及臨床特點(diǎn)。方法 收集2008年3月至2010年7月西藏自治區疾病預防控制中心結核病實(shí)驗室從患者痰標本分離培養的分枝桿菌培養物，用PNB/TCH鑒別培養基培養進(jìn)行菌種鑒定，采用WHO推薦的比例法進(jìn)行4種一線(xiàn)藥物異煙肼（INH）、利福平（RFP）、乙胺丁醇（EMB）和鏈霉素（SM）的藥敏試驗，并結合臨床資料分析NTM病例的臨床特征。
【關(guān)鍵字】 結核病,非結核分支桿菌,藥物耐藥性,臨床癥狀
中圖分類(lèi)號：R52文獻標識碼：B文章編號：1671-8194（2011）01-0005-02
Preliminarily Analyse on the Characteristics of Drug Resistance and Clinical Symptoms of Non-Tuberculosis Mycobacterium Infection in Tibet
HUANG Li-ping1, SHI Li1, WEI Shu-zhen2, BA Sang1, XI Luo1
(1 The Tibet Autonomous Region People's Hospital, Lasha 850000,China; 2 Fujian Center for Disease Control and Prevention, Fuzhou 350001,China)
[Abstract] Objective To explore the drug resistant situation and clinical features of non- tuberculosis mycobacterium (NTM) infection in Tibet. Methods From March 2008 to July 2010, 412 strains isolated from sputum were identified and conducted drug susceptibility test in laboratory in Tibet Center for Disease Control and Prevention, and the clinical data of 18 patients infected with NTM were analyzed. Results 18 strains of NTM was identified from 412 strains of mycobacterium, occupied 4.4%. The drugs (INH, RFP, SM and EMB)resistant rate was 88.9%, 77.8%, 94.4% and 22.2% respectively. The multi-drug resistant rate was 77.8%,and the total rate of drugs resistantance was100%.The main symptoms of patients infected NTM were cough, expectoration, fever and haemoptysis and so on. And wide range of lung had pathological change when the patients infected NTM, which was more common in the middle-aged patients. Conclusions NTM also exist in Tibet autonomous region. NTM was resistant to INH, RFP and SM. And the treatment programs of lung disease by NTM is need to be regularized.
分枝桿菌屬中除結核分枝菌和麻風(fēng)分枝菌外，還有許多具有抗酸染色特性的菌群。自1885年最早分離出恥垢分枝桿菌以來(lái)，迄今已發(fā)現百種以上，歷來(lái)對此命名甚多，目前將除結核分枝桿菌復合群和麻風(fēng)分枝桿菌之外的分枝桿菌統稱(chēng)為非結核分枝桿菌 （non-tuberculosismycobacterium, NTM）這個(gè)名稱(chēng)[1]。近年來(lái)，結核病的發(fā)病有上升趨勢，難治、復治結核患者中，部分是非結核分枝桿菌引起的非結核分枝桿菌肺病，但常被醫生疏忽。近年來(lái)，國外NTM病的發(fā)病率增加[2]，國內有NTM引起的肺病及醫院感染屢有報道[3-5]。為了解西藏NTM菌株的耐藥情況和NTM肺病的臨床特點(diǎn)，我們對2008年3月至2010年7月在西藏疾病預防控制中心結核病實(shí)驗室分離、培養的分枝桿菌培養物菌種鑒定、耐藥性檢測及其臨床資料分析。
