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目的 探讨耐多药肺结核病人痰菌是否存在耐药不均一性。方法 取 1例耐多药肺结核病人痰分离培养物制成的菌悬液 ,用 8 0 μm孔径醋酸纤维膜过滤得到单条结核菌分散存在的菌悬液 ,稀释后接种培养 ,挑取2 4个单菌落 ,再分别传代培养获得 2 4个结核菌的纯种。再采取中国标准绝对浓度法对 2 4个纯种菌株进行药物(INH、RFP、SM、EMB)敏感性试验 ,以敏感株H37Rv为对照。结果 从耐多药肺结核病人的分离株得到的 2 4个纯种结核菌中 ,对INH敏感 1个 ( 4 2 % )、低耐 2 2个 ( 91 6% )、高耐 1个 ( 4 2 % ) ;对RFP敏感 2个 ( 8 3 % )、低耐 2个( 8 3 % )、高耐 2 0个 ( 83 4% ) ;对SM敏感 1个 ( 4 2 % )、低耐 0个 ( 0 % )、高耐 2 3个 ( 95 8% ) ;对EMB全部敏感。结论 耐多药肺结核病人的痰菌对多种抗结核药物均存在耐药不均一性 ,敏感菌与耐药菌、低耐菌与高耐菌混合存在 ,敏感菌为极少数 ,耐药菌占绝大多数
Objective To investigate whether there is resistance heterogeneity in sputum of MDR-TB patients. Methods One bacterial suspension of sputum from multidrug-resistant pulmonary tuberculosis patients was obtained. The bacterial suspension with single tubercle bacillus was obtained by filtration through 80 μm pore size cellulose acetate membrane. After dilution, the bacterial suspension was inoculated and cultured, and 24 Single colonies, and then subculture were 24 strains of purebred strains of TB. Then the Chinese standard absolute concentration method for 24 strains of pure strains of drugs (INH, RFP, SM, EMB) sensitivity test to sensitive strains H37Rv as a control. Results Of the 24 strains of pure Mycobacterium tuberculosis isolated from MDR-TB patients, 1 (42%) were sensitive to INH, 2 (91.6%) were low resistant and 1 2 (83%) were sensitive to RFP, 2 were low resistant (83%), 20 were highly resistant (83 4%), 1 were sensitive to SM (42%) and 0 were low resistant (0%), high resistance 23 (95 8%); all EMB-sensitive. Conclusions The sputum bacterium in MDR-TB patients has heterogeneous resistance to many kinds of anti-tuberculosis drugs. There are mixed susceptible and resistant bacteria, mixed with low bacteriostasis and high bacteriostasis. The number of sensitive bacteria is very few, Mostly