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中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (1): 53-56.

• 论著 • 上一篇    下一篇

广州市依赖药物结核分枝杆菌分离率的初步调研

吴龙章 罗春明 吴幸怡 潘美玉 许蕴怡   

  1. 广州市胸科医院 广州 510095
  • 收稿日期:2009-11-07 出版日期:2011-01-20 发布日期:2012-01-19

The preliminary investigation in the isolation rate of drug-dependent Mycobacterium tuberculosisin Guangzhou

Wu Longzhang, Luo Chunming, Wu Xingyi, Pan Meiyu, Xu Yunyi   

  1. Guangzhou Chest Hospital, Guangzhou, 510095
  • Received:2009-11-07 Online:2011-01-20 Published:2012-01-19
  • Contact: Wu Longzhang E-mail:wlz8160@yahoo.cn

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摘要： 目的 了解和分析广州市依赖药物结核分枝杆菌的分离率，为临床第一线治疗结核病提供科学依据。 方法 对临床分离出的3 911株经实验室鉴定确证为结核分枝杆菌，采用罗氏药敏方法对临床常用的11种药物（包括利福平R、异烟肼H、链霉素S、乙胺丁醇E、环丙沙星C、左氧氟沙星Lfx、硫酸阿米卡星Am、丙硫异烟胺Pto、莫西沙星Mfx、克拉霉素Clr、力克菲蒺D）进行结核分枝杆菌的药物依赖性测定。 结果 3 911株结核分枝杆菌中，有159例患者共分离出192株对上述11种药物中的其中10种有程度不同的药物依赖性，依赖药物分离率为4.9%（192/3 911）；其中依赖R分离率为 2.7%（104/3 911）、其次H 2.4%（92/3 911）、S 1.0%（38/3 911）、C 0.4%（16/3 911）、Lfx 0.3%（12/3 911）、Am 0.3%（10/3 911）、E 0.2%（8/3 911）和Pto 0.1%（5/3 911）以及Mfx、Clr各0.1%（3/3 911）；暂未见力克菲蒺有结核分枝杆菌依赖现象；在159例患者中，有25例为广泛耐多药结核（XDR-TB）患者，110例为耐多药结核（MDR-TB）患者，二者占依赖药物结核分枝杆菌感染的84.9%（135/159）。 结论 结核分枝杆菌对药物的依赖性，以R、H为主，对Mfx、Clr的依赖率最低；而依赖药物结核分枝杆菌感染患者中，绝大部分均为MDR-TB和XDR-TB患者，这是值得临床第一线关注的严重问题。

关键词: 分枝杆菌, 结核, 抗药性, 多种, 细菌

Abstract: Objective To investigate the isolation rate of drug-dependent Mycobacterium tuberculosis in Guangzhou, and to provide scientific evidence for the clinical treatment.  Methods 3 911 M. tuberculosisstrains isolated and identified were analyzed the dependence on 11 frequently-used drugs (including Rifampin R, Isoniazid H, Streptomycin S, Ethambutol E, Ciprofloxacin C, Levofloxacin Lfx, Amikacin Am, Prothionamide Pto, Moxifloxacin M, Clarithromycin Clr, Dipasic D) using L-J drug susceptibility test.   Results Of 3 911 M. tuberculosisisolates, 192 strains isolated from 159 patients had dependence on 10 of 11 drugs, the isolation rate was 4.9% (192/3 911).  Among  these, the isolation rate of dependence on R was 2.7% (104/3 911), H was 2.4% ( 92/3 911 ), S was 1.0% (38/3 911), C was 0.4% (16/3 911), Lfx was 0.3% (12/3 911), Am was 0.3% ( 10/3 911 ), E was 0.2% (8/3 911), and Pto was 0.1% (5/3 911), both of Mfx and Clr were 0.1% (3/3 911), respectively. Dependence upon Dipasic was not observed. Of 159 patients, 25 were extensively drug-resistant TB (XDR-TB), and 110 were multiple drug-resistant TB (MDR-TB), accounting for 84.9% (135/159) cases of drug-dependent TB.  Conclusions The drug-dependence ofM. tuberculosisin Guangzhou was primarily upon R and H, whereas dependence rate upon Mfx and Clr were the lowest. Furthermore, the majority of drug-dependent TB was MDR-TB or XDR-TB.

Key words: Mycobacterium tuberculosis, drug resistance,mutiple,bacterial

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