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目的分析肺结核患者的菌型及耐药情况,为临床治疗肺结核提供有力的证据。方法肺结核患者痰菌培养阳性256例,用改良罗氏法培养进行痰培养,选择培养后的阳性菌株为标本,进行各种菌型鉴定及4种抗结核药物[链霉菌(SM)、异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)]的单药、二药、三药、四药的耐药性检测。结果 256例痰阳性菌株经罗氏培养,人型分枝杆菌247株(96.48%),牛型分枝杆菌7株(2.73%),非典型分枝杆菌2株(0.78%);其耐药率分别为耐单药59例(23.05%),耐二药30例(11.72%),耐三药12例(4.69%),耐四药4例(1.56%)。结论严格遵循抗结核药物治疗的原则,及时对结核菌型鉴定和耐药性及药敏的检测,随时调整化疗方案,增加药物疗效,降低耐药率,对有效控制结核病的传播及疾病有重要价值。
Objective To analyze the bacterial type and drug resistance in patients with pulmonary tuberculosis and provide strong evidence for the clinical treatment of pulmonary tuberculosis. Methods Totally 256 cases of sputum culture positive in patients with pulmonary tuberculosis were cultured in sputum with modified Roche method. The positive strains were selected for culturing and identification of various strains and identification of four kinds of antituberculosis drugs [Streptomyces (SM), Isoniazid (INH), rifampin (RFP), ethambutol (EMB) single drug, two drugs, three drugs, four drug resistance test. Results 256 sputum positive strains were cultured by Roche. 247 strains of Mycobacterium tuberculosis (96.48%), 7 strains of Mycobacterium bovis (2.73%) and 2 strains of Atypical mycobacterium (0.78% Resistant to monotherapy in 59 cases (23.05%), resistance to two drugs in 30 cases (11.72%), resistance to three drugs in 12 cases (4.69%), resistance to four drugs in 4 cases (1.56%). Conclusion Strict adherence to the principle of anti-TB drug treatment, timely identification of tuberculosis and drug resistance and susceptibility testing, at any time to adjust the chemotherapy regimen to increase drug efficacy and reduce drug resistance rate, effective in controlling the spread of tuberculosis and disease is important value.