蔡静, 张鑫, 魏黛珏, 李凯, 同重湘. 甘肃省53株非结核分枝杆菌对9种常用抗结核药物的敏感性分析[J]. 疾病监测, 2018, 33(6): 515-519. DOI: 10.3784/j.issn.1003-9961.2018.06.016
引用本文: 蔡静, 张鑫, 魏黛珏, 李凯, 同重湘. 甘肃省53株非结核分枝杆菌对9种常用抗结核药物的敏感性分析[J]. 疾病监测, 2018, 33(6): 515-519. DOI: 10.3784/j.issn.1003-9961.2018.06.016
Cai Jing, Zhang Xin, Wei Daijue, Li Kai, Tong Chongxiang. Analysis on susceptibility of 53 non tuberculosis mycobacterium isolates to 9 common anti-tuberculosis drugs in Gansu[J]. Disease Surveillance, 2018, 33(6): 515-519. DOI: 10.3784/j.issn.1003-9961.2018.06.016
Citation: Cai Jing, Zhang Xin, Wei Daijue, Li Kai, Tong Chongxiang. Analysis on susceptibility of 53 non tuberculosis mycobacterium isolates to 9 common anti-tuberculosis drugs in Gansu[J]. Disease Surveillance, 2018, 33(6): 515-519. DOI: 10.3784/j.issn.1003-9961.2018.06.016

甘肃省53株非结核分枝杆菌对9种常用抗结核药物的敏感性分析

Analysis on susceptibility of 53 non tuberculosis mycobacterium isolates to 9 common anti-tuberculosis drugs in Gansu

  • 摘要: 目的 初步了解2012-2014年甘肃省临床分离的非结核分枝杆菌(NTM)对常用抗结核药物的耐药情况。方法 收集临床分枝杆菌分离株,用PNB/TCH生长试验和基于16S rRNA基因的序列分析法鉴定NTM。采用传统固体罗氏培养基绝对浓度法对NTM进行9种常用抗结核药物链霉素(SM)、利福平(RFP)、丙硫异烟胺(TH1321)、异烟肼(INH)、对氨基水杨酸钠(PAS)、左氧氟沙星(LVFX)、乙胺丁醇(EMB)、卡那霉素(KAN)和吡嗪酰胺(PZA)的敏感性测试。结果 共收集到分枝杆菌1 081株,经鉴定53株为NTM,分离率为4.90%。其中胞内分枝杆菌最多,为36株;其次是堪萨斯分枝杆菌,为8株;其他依次是鸟分枝杆菌4株、戈登分枝杆菌2株、脓肿分枝杆菌2株和偶然分枝杆菌1株。药敏结果显示,耐药率从高到低依次为RFP(73.58%)、TH1321(69.81%)、INH(67.92%)、SM(62.26%)、PAS(60.38%)、PZA(47.17%)、EMB(28.30%)、LVFX(26.41%)、KAN(15.09%),其中耐药株49株,耐药率为92.45%,NTM对9种抗结核药物的耐药程度有差异。结论 NTM对抗结核药物敏感性差,应参照NTM药敏结果选择合理的药物,提高治愈率,减少耐药发生。

     

    Abstract: Objective To understand the susceptibility of non tuberculosis mycobacterium (NTM)isolates to common anti-tuberculosis drugs in Gansu province. Methods The clinical isolates of Mycobacterium were collected to identify NTM by means of PNB/TCH differential media and DNA sequence analysis of 16S rRNA gene. The drug resistance of NTM strains to streptomycin, rifampicin,protionamide (TH1321),isoniazide,sodium aminosalicylate,levofloxacin,ethambutol, kanamycin and pyrazinamide were tested by using absolute concentration method. Results A total of 53 NTM strains were identified from 1 081 clinical mycobacterial isolates,the isolation rate was 4.90%,from which 6 species of NTM were identified including 36 M. intracellulare strains (67.92%),8 M. kansasii strains (15.09%),4 M. avium strains (7.55%),2 M. gordon strains (3.77%),2 M. abscessus strains (3.77%) and 1 M. fortuitum strain (1.89%). Forty nine NTM strains showed different resistance to 9 anti-tuberculosis drugs,the overall resistant rate was 92.45%. The resistant rate to rifampicin was highest (73.58%),followed by that to protionamide (TH1321) (69.81%),isoniazide (67.92%),streptomycin (62.26%), sodium aminosalicylate (60.38%),pyrazinamide (47.17%),ethambutol (28.30%),levofloxacin (26.41%)and kanamycin (15.09%). Conclusion The susceptibility of NTM to common anti-tuberculosis drugs is poor. It is necessary to use anti-tuberculosis drugs rationally according to the results of drug susceptibility test to increase cure arte and reduce drug resistance.

     

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