CAJ | 학술논문

目的研究衢州地区痰涂片阳性肺结核患者对常用抗结核药物的耐药情况,为结核病控制和临床用药提供对策.方法对衢州地区的743例痰涂片阳性肺结核患者痰标本进行酸性改良罗氏培养基痰培养,将培养阳性菌株以硝基苯甲酸(PNB)培养基和噻吩-2-2羧酸肼(TCH)培养基进行菌种鉴定,采用绝对浓度间接法对异烟肼(INH)、利福平(RFP)、链霉素(SM)、氧氟沙星(OFLX)、乙胺丁醇(EMB)、卡那霉素(KM)6种抗结核药物进行敏感性试验.结果743例获得菌种鉴定和药物敏感试验结果者中有结核分枝杆菌复合群728例(97.98%),非结核分枝杆菌15例(2.02%).728例结核分枝杆菌复合群中总耐药率为26.63%,初治耐药率为19.35%,复治耐药率为57.32%;总耐多药率为5.36%,初治耐多药率1.39%,复治耐多药率36.59%.6种抗结核药物的耐药顺序依次为INH 8.20%、SM 7.74%、OFLX 4.80%、RFP 1.86%、KM 1.24%、EMB 1.08%.结论衢州地区肺结核患者中耐药情况较为严重,应开展分枝杆菌培养和药敏试验并根据药敏结果组成个体化化疗方案,同时进一步落实和提高非住院肺结核患者全面监督化学治疗(DOTS)质量,提高各类患者的治愈率,减少各种耐药的发生概率.
목적연구구주지구담도편양성폐결핵환자대상용항결핵약물적내약정황,위결핵병공제화림상용약제공대책.방법대구주지구적743례담도편양성폐결핵환자담표본진행산성개량라씨배양기담배양,장배양양성균주이초기분갑산(PNB)배양기화새분-2-2최산정(TCH)배양기진행균충감정,채용절대농도간접법대이연정(INH)、리복평(RFP)、련매소(SM)、양불사성(OFLX)、을알정순(EMB)、잡나매소(KM)6충항결핵약물진행민감성시험.결과743례획득균충감정화약물민감시험결과자중유결핵분지간균복합군728례(97.98%),비결핵분지간균15례(2.02%).728례결핵분지간균복합군중총내약솔위26.63%,초치내약솔위19.35%,복치내약솔위57.32%;총내다약솔위5.36%,초치내다약솔1.39%,복치내다약솔36.59%.6충항결핵약물적내약순서의차위INH 8.20%、SM 7.74%、OFLX 4.80%、RFP 1.86%、KM 1.24%、EMB 1.08%.결론구주지구폐결핵환자중내약정황교위엄중,응개전분지간균배양화약민시험병근거약민결과조성개체화화료방안,동시진일보락실화제고비주원폐결핵환자전면감독화학치료(DOTS)질량,제고각류환자적치유솔,감소각충내약적발생개솔.
Objective To evaluate the culture and drug-resistance tests of mycobacterium tuberculosis in patients with positive smears. Methods Sputum samples were col ected from 743 tuberculosis patients in Quzhou city from March 2010 to November 2011. The samples were cultured with acidic Lowenstein medium;and in culture-positive samples. PNB medium and TCH medium were used for strain identification. The susceptibility tests were performed with six kinds of anti-TB drugs. Results Among 743 cases there were 728 cases (97.98%) of mycobacterium tuberculosis complex group and 15 cases (2.02%) of non-tuberculous mycobacteria. In 728 cases of mycobacterium tuberculosis complex group the overal drug resistant rate was 26.63%;the drug resistance rate in initial treatment was19.35%and that in retreatment was 57.32%. The overall multidrug resis-tance rate was 5.36%;the multidrug resistance rate in initial treatment was 1.39%and that in retreatment was 36.59%. The resis-tance rates for 6 kinds of anti-TB drugs in orders were INH 8.20%, SM 7.74%, OFLX 4.80%, RFP 1.86%, KM 1.24% and EMB 1.08%. Conclusion Drug resistance in TB patients of Quzhou region is relatively serious, personalized chemotherapy based on mycobacterial culture and sensitivity test is necessary and the the quality of DOTS should be improved.