欢迎访问《微生物与感染》官方网站,今天是
论著

广西地区艾滋病患者临床标本分枝杆菌培养及耐药性分析

  • 蒙志好1 ,
  • 韦永忠1 ,
  • 廖光付1 ,
  • 吕康言1 ,
  • 陆雪萍1 ,
  • 左勇1 ,
  • 蓝珂1 ,
  • 唐月璐1 ,
  • 沈银忠2
展开
  • 1. 广西壮族自治区龙潭医院感染科,广西 柳州 545005; 2. 上海市(复旦大学附属)公共卫生临床中心感染与免疫科,上海 201508

收稿日期: 2020-09-04

  网络出版日期: 2021-04-25

基金资助

“十三五”国家科技重大专项(2017ZX10202101),广西壮族自治区卫健委重点课题(重2011067),广西壮族自治区卫健委自筹经费课题(Z2008023,Z2016428)

Isolation and drug resistance of Mycobacterium from clinical specimens of acquired immunodeficiency syndrome patients in Guangxi

  • MENG Zhihao1 ,
  • WEI Yongzhong1 ,
  • LIAO Guangfu1 ,
  • LU Kangyan1 ,
  • LU Xueping1 ,
  • ZUO Yong1 ,
  • LAN Ke1 ,
  • TANG Yuelu1 ,
  • SHEN Yinzhong2
Expand
  • 1. Department of Infectious Diseases, Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China; 2. Department of Infection and Immunity, Shanghai Public Health Clinical Center Affliated to Fudan University, Shanghai 201508, China

Received date: 2020-09-04

  Online published: 2021-04-25

摘要

为探讨艾滋病患者临床标本分枝杆菌培养阳性率、菌种类型及耐药状况,本研究对2010年1月—2019年12月在广西某医院就诊的艾滋病患者的临床标本进行分枝杆菌培养,分离鉴定后用8种以上抗结核药物进行药敏试验。结果显示,艾滋病患者临床标本分枝杆菌培养总阳性率为15.68%(2 163/13 795),脓液、分泌物、组织标本、胸腹水等标本阳性率高。经初步菌种鉴定,结核分枝杆菌复合群占77.95%(1 442/1 850),非结核分枝杆菌占22.05%(408/1 850),后者10年中占比15.71%~26.07%,年间差异无统计学意义(χ2=10.442,P>0.05)。结核分枝杆菌的总耐药率为23.30%(336/1 442),年间差异有统计学意义(χ2=18.901,P=0.026),其对异烟肼的耐药率为12.14%(175/1 442)、对利福平为10.54%(152/1 442)、对链霉素为9.29%(134/1 442)、对氧氟沙星为5.62%(81/1 442)、对乙胺丁醇为3.05%(44/1 442)、对对氨基水杨酸为1.80%(26/1 442)、对卡那霉素为1.32%(19/1 442),耐多药率、广泛耐药率分别为5.48%(79/1 442)、0.28%(4/1 442)。研究表明,艾滋病患者临床标本分枝杆菌培养阳性率高,其中非结核分枝杆菌占 15.71%~26.07%,10年来基本稳定。结核分枝杆菌对异烟肼耐药率最高,利福平次之。因此,应该对艾滋病患者临床标本进行分枝杆菌培养、鉴定和耐药性检测,从而为临床诊治提供可靠依据。

本文引用格式

蒙志好1 , 韦永忠1 , 廖光付1 , 吕康言1 , 陆雪萍1 , 左勇1 , 蓝珂1 , 唐月璐1 , 沈银忠2 . 广西地区艾滋病患者临床标本分枝杆菌培养及耐药性分析[J]. 微生物与感染, 2021 , 16(2) : 103 -109 . DOI: 10.3969/j.issn.1673-6184.2021.02.005

Abstract

To investigate the positive rate, species and drug resistance of Mycobacteria in clinical specimens of acquired immunodeficiency syndrome (AIDS) patients, the AIDS patients in a hospital in Guangxi during January 2010 and December 2019 were collected and their clinical specimens were cultured with acid-fast bacilli. The antimicrobial susceptibility testing was conducted with more than eight anti-tuberculosis drugs after isolation and identification. The overall positive rate was 15.68% (2 163/13 795). The positive rate was high in pus, secretions, various tissue specimens, pleural effusion, and ascites. The species identification results showed that Mycobacteria tuberculosis compound group accounted for 77.95% (1 442/1 850) and non-tuberculosis Mycobacterium (NTM) accounted for 22.05% (408/1 850). The latter accounted for 15.71%-26.07% over 10 years, with no statistically significant difference between years (χ2=10.442, P>0.05). The overall drug resistance rate was 23.30% (336/1 442), with a significant difference over a 10-year period (χ2=18.901, P=0.026). The rates of resistance to isoniazid, rifampicin, streptomycin, ofloxacin, ethambutol, p-amino salicylic acid, kanamycin were 12.14% (175/1 442), 10.54% (152/336), 9.29% (134/1 442), 5.62% (81/1 442), 3.05% (44/1 442), 1.80% (26/1 442), 1.32% (19/1 442), respectively. The prevalence of multidrug-resistant tuberculosis (DR-TB) and extensively drug-resistant tuberculosis (XDR-TB) was 5.48% (79/1 442) and 0.28% (4/1 442), respectively. It is confirmed that the positive rate of Mycobacteria isolated from the clinical specimens of AIDS patients is high and NTM accounts for a high proportion. The drug resistance rate of Mycobacterium tuberculosis to commonly used anti-tuberculosis drugs is high. It is suggested that clinical Mycobacterium identification and antimicrobial susceptibility testing should be carried out to provide a reliable basis for clinical diagnosis and treatment.
文章导航

/