文章摘要
陈惠芬,黄秋生.耐多药结核分枝杆菌对二线抗结核药物敏感性观察[J].南京医科大学学报,2014,(1):
耐多药结核分枝杆菌对二线抗结核药物敏感性观察
Study on susceptibility of multiple drug-resistance Mycobacterium tuberculosis to second-line anti-TB drugs
投稿时间:2013-07-25  修订日期:2013-12-08
DOI:10.7655/NYDXBNS201401034
中文关键词: 结核分枝杆菌  耐多药结核分枝杆菌  二线抗结核药物  药敏试验
英文关键词: Mycobacterium tuberculosis  Multiple drug-resistance Mycobacterium tuberculosis  Second-line anti-TB drugs  drug sensitivity test
基金项目:
作者单位E-mail
陈惠芬 无锡市第五人民医院 1419451325@qq.com 
黄秋生 无锡市第五人民医院 hqsheng586@sina.com 
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中文摘要:
      目的:了解本地区耐多药结核分枝杆菌对二线抗结核药物耐药状况,为治疗耐多药结核病提供参考。方法:收集本院2010年1月~2012年12月来自涂阳肺结核患者的痰培养阳性、经菌种鉴定和一线药物的药物敏感性试验确定为耐多药的结核分枝杆菌株77株,采用绝对浓度法对五种二线抗结核药物:氧氟沙星、对氨基水杨酸、丁胺卡那、卷曲霉素及丙硫异烟胺进行药物敏感性检测,并对耐药状况进行分析。结果:2010~2012年本院培养分离出MDR-MTB77株,其中25株来自初治肺结核患者,52株来自复治肺结核患者,对5种二线药物的总耐药率为72.73%(56/77),初治耐药率为60.0%(15/25),复治耐药率71.15%(37/52);XDR-MTB21株占27.27%(21/77),其中来自初治者1例(4%),来自复治者20例(38.46%)。MDR-MTB对PAS、AMK、CPM、OFLX、Pto的耐药率分别为 33.77%、14.29%、19.48%、64.94%和24.68%。MDR-MTB对不同组合的二线抗结核药物(OFLX Pto、OFLX CPM Pto、OFLX AMK Pto、OFLX Pto PAS、 CPM PAS OFLX Pto、和AMK PAS OFLX Pto)分别为23.38%、10.39%、5.19%、12.99%、6.49% 和6.49%。结论:无锡地区MDR-MTB对二线抗结核药物耐药性较严重,应加强对MDR-MTB的耐药性监测,合理选择二线抗结核药物治疗MDR-TB。
英文摘要:
      Objective To study the drug resistance of multiple drug-resistance MTB to sceond-line Anti-TB Drugs in Wuxi and provide reference for clinical treatment. Mothodes 77 multi-drug MTB were collected from tuberculosis patients who came from Wuxi NO5 hospital between Jan 2010 and Dec 2012; Drug susceptibility on 5 second-line drugs including PAS, AMK, CPM, OFLX and Pto were tested. Results From Jan 2010 to Dec 2012, 77 MDR-MTB were obtained in which there were 25 MDR-MTB from initial cases and 52 MDR-MTB from retreated cases. The total drug- resistance rate of the 5 drugs was 72.73%(56/77). The drug-resistant rate of the first treated cases and the retreated cases was 60.0%(15/25) and 71.15%(37/52)respcetively. The drug-resistance rate to PAS, AMK, CPM, OFLX, Pto was 33.77%, 14.29%, 19.48%, 64.94% and 24.68% respectively. There were 21 XDR-MTB cases accounting for 27.27% (21/77), including 1 initial case and 20 retreated cases. The drug-resistant rate to OFLX Pto, OFLX CPM Pto, OFLX AMK Pto, OFLX Pto PAS, CPM PAS OFLX Pto and AMK PAS OFLX Pto was 23.38%,10.39%, 5.19%, 12.99%, 6.49% and 6.49% respectively. Conclusion The drug resistant status of MDR-MTB to second anti-TB drugs is serious, we should further monitor the drug resistance of MDR-MTB, and chosen second anit-TB drugs reasonly in MDR-TB treatment.
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