结核病与肺部健康杂志 ›› 2014, Vol. 3 ›› Issue (2): 91-95.doi: 10.3969/j.issn.2095-3755.2014.02.004

• 论著 • 上一篇    下一篇

苏州市痰培养阳性肺结核患者的菌型鉴定及药物敏感性试验结果分析

蒋骏, 张晓龙   

  1. 215004 江苏省苏州市疾病预防控制中心结核病防治科
  • 收稿日期:2013-09-19 出版日期:2014-04-20 发布日期:2014-04-20
  • 通信作者: 蒋骏,Email:junjiang.jj@163.com

Analysis on the results of bacteria identification and drug sensitivity test among patients with culture-positive pulmonary tuberculosis in Suzhou

JIANG Jun,ZHANG Xiao-long.   

  1. Department for Tuberculosis Control and Prevention of Suzhou Center for Disease Control and Prevention, Jiangsu Province, Suzhou 215004, China
  • Received:2013-09-19 Online:2014-04-20 Published:2014-04-20
  • Contact: JIANG Jun,Email: junjiang.jj@163.com

摘要: 目的 分析苏州市痰培养阳性肺结核患者的分枝杆菌分布及耐药情况,为诊断与治疗分枝杆菌感染提供参考依据。方法 对苏州市2012年1月至2013年5月371例痰培养阳性的肺结核患者进行菌型鉴定及药物敏感性试验并进行结果分析。同时收集患者的基本情况,利用SPSS 19.0软件中的非条件logistic回归模型分析影响分枝杆菌分布的相关因素。结果 371例痰培养阳性患者中,结核分枝杆菌患者为316例,占85.2%;非结核分枝杆菌(NTM)患者55例,占14.8%。耐多药患者为79例,总耐多药率为21.3%;其中结核分枝杆菌32例(10.1%,32/316),非结核分枝杆菌47例(85.5%,47/55);结核分枝杆菌与非结核分枝杆菌患者耐多药率差异有统计学意义(χ2 =158.608,P<0.001)。多因素logistic回归分析显示,患者≥65岁(OR=0.108, 95%CI= 0.016~0.711,P=0.021)、抗结核治疗史(OR=0.277,95%CI=0.145~0.532, P<0.001) 对于结核分枝杆菌与非结核分枝杆菌分布是独立的影响因素。结论 苏州市痰培养阳性肺结核患者中耐药情况严重,同时非结核分枝杆菌耐多药率较高,应进一步完善现有诊断治疗模式。

Abstract: Objective In order to provide more reference to the diagnosis and treatment of pulmonary tuberculosis (TB), to analyze the distributions of non-tuberculous mycobacterium (NTM) and drug-resistant (DR) TB among the patients with culture-positive pulmonary TB in Suzhou.Methods Identification of bacteria and drug sensitivity test (DST) were performed for 371 patients with culture-positive pulmonary TB who were detected from January 2012 to May 2013 in Suzhou city and the results of the tests were analyzed; at the same time, the basic information of those patients were collected. With the SPSS 19.0 software, the unconditional logistic regression model was used to identify the associated factors influencing the distribution of Mycobacterium tuberculosis (Mtb) and NTM.Results Among 371 culture-positive pulmonary TB patients, 316 patients (85.2%) were Mtb while 55 patients (14.8%) were NTM; 79 patients had multidrug-resistance (MDR), so the overall MDR rate was 21.3%. Out of the 79 patients with MDR, 32 patients (10.1%, 32/316) were Mtb while 47 patients (85.5%, 47/55) were NTM. The MDR rate in NTM patients was significantly higher than that in Mtb patients (χ2=158.608, P<0.001). Multivariate logistic regression analysis showed that the following two factors were the independent factors influencing the distribution of Mtb and NTM: age ≥65 year (OR=0.108, 95%CI=0.016-0.711, P=0.021) and the history of anti-TB treatment (OR=0.277, 95%CI=0.145-0.532, P<0.001).Conclusion The situation of drug resistance and the infection of NTM in patients with culture-positive pulmonary TB are serious in Suzhou city, so the diagnosis and treatment patterns should be improved.