关键词: 结核, 脊柱/治疗, 分枝杆菌, 结核, 抗药性, 细菌, 微生物敏感性试验

Abstract: Objective  To analyze the drug-resistance, cause of drug-resistance and principle of management. Methods  1057 patients admitted and diagnosed definitely as spinal tuberculosis in our hospital from Jan. 2005 to Jan. 2012 were enrolled. The samples of pus and caseous matter collected by puncture or operation were culture and drug susceptible testing(DST). Results  Of 1057 cases, 128 cases were culture positive(128/1057,12.1%). Among 128 patients with drug-resistance tuberculosis, the cases of drug-resistant to isoniazid, rifampicin and streptomycin were 22, 16 and 27, respectively. The rates of drug-resistance were 17.2%, 12.5%and 21.1%, respectively. High concentration drug-resistance was serious and common in rifampicin, rifapentine and streptomycin which accounted for 100.0%(16/16), 75.0%(12/16) and 92.6%(25/27) among drug-resistant strains. The rate of cases with multi-drug resistant tuberculosis(MDR-TB) which all belonged to retreatment were 16.4%(21/128). All patients were given standardized or individual treatment plus selective operation according to the result of DST. All patients were cured. Conclusion  Mycobacterium tuberculosis from focus of spinal tuberculosis was mainly resistant to first-line drugs such as isoniazid, rifampicin, rifapentine and streptomycin. All patients with MDR-TB were retreatment and were mainly secondary tuberculosis. It is key step for efficacy that rational treatment according to DST result earlier is performed. It is also useful to prevent MDR-TB.

Key words: Tuberculosis, spinal/therapy, Mycobacterium tuberculosis, Drug resistance, bacterial, Microbial sensitivity tests