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目的探讨近10年广州市旧城区非结核分枝杆菌(MOTT)流行状况及流行趋势。方法分析1994-2003年广州市结核病肺部肿瘤防治所结核专科门诊患者的分枝杆菌培养、分群鉴定、部分MOTT菌株耐药性测定及菌种鉴定情况。结果检出12634株分枝杆菌,其中MOTT794株,其分离率为6.28%,年分离率3.51%～10.06%,10年上升幅度为73.15%;对613株MOTT进行异烟肼(H)、利福平(R)、链霉素(SM)和乙胺丁醇(EMB)4种主要抗结核药物耐药性测定,至少耐R和H的菌株512株,耐多药率为83.5%,各年耐多药率71.4%～93.9%;菌种分布主要为致病性鸟胞内、龟脓肿分枝杆菌和瘰疬、偶发分枝杆菌等条件致病性MOTT;45岁以上年龄组为MOTT易感人群,55～65岁为感染高峰,男女性别构成平均为3.36∶1。结论10年来,广州市旧城区人口MOTT流行情况及长期变异趋势和全国水平相当,但分离率呈大幅上升趋势,主要为致病性菌种,并具有极高的耐药率,故对MOTT致病的流行病学研究应纳入国家结核病控制规划。
Objective To investigate the prevalence and epidemiological trend of Mycobacterium tuberculosis (MOTT) in the old city of Guangzhou in recent 10 years. Methods The analysis of mycobacterium culture, cluster identification, partial drug resistance of MOTT strains and identification of strains in tuberculosis specialist outpatient department of Guangzhou Tuberculosis and Lung Cancer Hospital from 1994 to 2003 were analyzed. Results A total of 12634 mycobacteria were detected, of which MOTT794 was isolated with the rate of 6.28%, the annual isolation rate was 3. 51% -10.06%, and the increase rate was 73.15% in 10 years. Isoniazid (6) The resistance of four major anti-tuberculosis drugs, Fupin (R), Streptomycin (SM) and Ethambutol (EMB), was determined. At least 512 R and H resistant strains were obtained, The annual multidrug resistance rate was 71.4% -93.9%. The pathogenic MOTT was mainly distributed in pathogenic avian cells, Mycobacterium turtle abscesses, Mycoplasma gonorrhoeae and Mycobacterium fortunei, and Mycobacterium tuberculosis. The age group over 45 years old was MOTT Susceptible populations, 55 to 65 years old peaked infection, male and female constitute an average of 3.36: 1. Conclusions In the past 10 years, the prevalence and long-term variation trend of population MOTT in the old urban area of Guangzhou are similar to those of the whole country. However, the isolation rate shows a substantial upward trend, mainly due to pathogenic bacteria and has a very high drug resistance rate. Therefore, Epidemiological studies of disease should be integrated into national tuberculosis control programs.