目的：探讨肺结核耐药患者结核分枝杆菌菌型分布及耐药情况。方法收集本院2012年6月至2014年6月收治的568例肺结核患者的病灶标本进行细菌培养和鉴定，并进行药物敏感试验，分析结核分枝杆菌菌型分布和耐药情况。结果214株结核分枝杆菌菌株中，人结核分枝杆菌198株，牛结核分枝杆菌4株，非结核分枝杆菌（nontuberculoaus mycobacteria，NTM）12株，三种类型结核分枝杆菌所占百分比比较差异具有显著性（P＜0.05）；人结核分枝杆菌耐药58株，牛结核分枝杆菌耐药1株，NTM耐药1株，三者比较差异显著（P＜0.05）；人结核分枝杆菌耐多药12株，牛结核分枝杆菌与NTM均无耐多药病例，三者比较差异显著（P＜0.05）；10种药物耐药率最高的为链霉素，最低的为对氨基水杨酸，二者耐药率比较差异显著（P＜0.05）；Logistic回归分析发现治疗时间与耐药率呈显著相关性（P＜0.05）。结论结核分枝杆菌耐药状况较为严重，应加强耐药性监测，并依据药物敏感试验选择合理有效化疗方案。%ObjectiveTo investigate the mycobacterium tuberculosis bacterium distribution of drug-resistant tuberculosis patients, and analyze its drug resistance feature.Method568 cases of pulmonary tuberculosis patients’ lesion specimen were collected from June 2012 to June 2014, and used bacterial culture, identiifcation and drug sensitization experiments, the distribution of mycobacterium tuberculosis bacteria and drug resistance were analyzed.ResultThere were 198 cases of human type mycobacterium tuberculosis, 4 cases of mycobacterium bovis, 12 cases of NTM in 214 cases of culture-positive pulmonary tuberculosis. The difference of percentage among three types of mycobacterium tuberculosis was signiifcantly (P<0.05). There were 58 cases of drug-resistant strains of mycobacterium tuberculosis, 1 case of drug resistance of cattle mycobacterium tuberculosis, 1 case of drug resistance NTM, the difference was signiifcant (P<0.05); 12 cases of multi drug resistance in human mycobacterium tuberculosis, and there were no multi drug resistance in mycobacterium bovis and NTM, the difference was signiifcant (P<0.05); drug sensitization experiments showed that the highest rates of drug resistance was SM, the lowest was PAS, the difference was signiifcantly (P<0.05); Logistic regression analysis showed that there was significant association between treatment duration and resistance rates (P<0.05).ConclusionTB drug resistance is more serious and should strengthen monitoring of drug resistance, and based on susceptibility testing to select reasonable and effective chemotherapy.
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