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目的了解西安市分支杆菌病原菌感染的流行状况,为制定结核病防治措施提供科学依据。方法采用流行病学抽样调查方法,选取陕西省西安市为调查点,于2005年5～8月对其13个区级结防所就诊的所有病人进行调查,每个病人收集三份痰标本。采用痰涂片和痰培养法检测病人痰标本,鉴别培养基培养法鉴定分支杆菌菌种。结果574位病人,涂片阳性113人,阳性率为19.69%,培养阳性病人150人,阳性率26.13%。后者明显高于前者,两者之间的差异具有显著统计学意义(!2=360.50,P<0.01),两者联合阳性率为26.83%。从137例病例痰标本中分离到251株分支杆菌菌株,结核分支杆菌、牛分支杆菌、非结核分支杆菌(NTM)和混合感染的比例分别是67.88%、5.84%、11.68%、14.60%。结论细菌培养法可明显提高阳性率;NTM感染流行状况应予以足够的重视。
Objective To understand the prevalence of mycobacterial pathogen infection in Xi’an and provide a scientific basis for the development of tuberculosis prevention and treatment measures. Methods The epidemiological sampling method was used in this study. Xi’an, Shaanxi Province was selected as the survey site. All the patients in the 13 district-level prevention and treatment clinics from May to August in 2005 were investigated. Three sputum samples were collected from each patient. Sputum smear and sputum culture were used to detect the sputum samples, identification of culture medium identification of mycobacterial species. Results 574 patients, smear-positive 113, the positive rate was 19.69%, the positive culture of 150 patients, the positive rate of 26.13%. The latter was significantly higher than the former, the difference between the two was statistically significant (! 2 = 360.50, P <0.01), the positive rate of the combination of the two was 26.83%. 251 strains of mycobacteria were isolated from 137 cases of sputum samples. The proportion of Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium tuberculosis and non-tuberculosis (NTM) and mixed infection were 67.88%, 5.84%, 11.68% and 14.60% respectively. Conclusion Bacterial culture method can significantly improve the positive rate; NTM infection prevalence should be paid enough attention.