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目的 了解浙江省12个区(县)分枝杆菌菌种流行情况及结核分枝杆菌的INH、RFP耐药相关基因特征.方法 收集2012年1月至2016年6月浙江省12个区(县)初诊为菌阳肺结核患者的2803株临床分离菌株标本,运用基因芯片技术进行菌种鉴定和INH、RFP耐药检测.结果 2803份菌株中,NTM占7.3％ (205株),前6位菌种为:胞内分枝杆菌101株,堪萨斯分枝杆菌50株,龟-脓肿分枝杆菌24株,鸟分枝杆菌16株,偶然分枝杆菌4株,浅黄色分枝杆菌1株;2598株MTB中耐INH者占12.5％(326株),耐RFP者占9.8％(254株),MDR占6.7％(173株).425株MTB耐药突变位点结果中,katG 315位点占INH耐药突变的81.1％ (279/344),rpoB 531位点占RFP耐药突变的56.6％ (155/274).结论 通过涂片诊断肺结核患者中有13.5％ (378/2803)为NTM和MDR感染,INH耐药的主要突变位点是katG 315,RFP耐药的主要突变位点是rpoB 531,在基层医疗机构积极推行分枝杆菌菌种鉴定技术和耐药检测技术将有利于加快我国结核病疫情控制.“,”Objective To analyze the epidemiological characteristics of Mycobacterium strains and drugresistance gene characteristics in Mycobacterium tuberculosis strains from 12 counties in Zhejiang Province,China.Methods From January,2012,to June,2016,a total of 2803 sputum positive samples (positive staining that confirmed growth of acid-fast bacilli) were collected from patients newly diagnosed with TB in Zhejiang Province.Mycobacteria Identification Array Kits and M.tuberculosis Drug Resistance Detection Array Kits were used to further identify and characterize the strains in each sample.Results We identified 2598 of the 2803 strains (92.7％),as Mycobacterium tuberculosis and 205 strains (7.3 ％) as NTM.NTM strains were further identified as follows:Mycobacterium intracellulare,101 isolates;Mycobacterium kansasii,50 isolates;Turtle/Mycobacterium abscessus,24 isolates;Mycobacterium avium,16 isolates;Mycobacterium fortuitum,4 isolates;light yellow Mycobacte rium,1 isolate.Among the 2598 M.tuberculosis strains there were 326 (12.5％) INH-resistant strains,254 (9.8％) RFP-resistant strains,and 173 (6.7％) MDR TB strains.Among the drug-resistant strains of M.tuberculosis,81.1％ (279/344) of the INH-resistant mutations were related to katG315,and 84 (60.0％) of 140 RFP-resistant mutations were associated with rpoB531.Conclusion Among the 2803 strains collected from patients in 12 counties of Zhejiang Province,378 (13.5％) were designated as either MDR TB or NTM.In addition,katG315 was the main point mutation associated with INH resistance in M.tuberculosis strains,and rpoB531 was the main point mutation for RFP resistance.Mycobacterium strain identification and drug-resistance testing are important in enhancing regulation and prevention of TB in basic medical institutions.