摘要
目的分析矽肺患者结核分枝杆菌临床检验结果,并对分离菌株进行药敏检测。方法以2011年10月至2013年10月临床诊断为矽肺合并肺结核的127例患者(矽肺结核组)和53例无合并肺结核矽肺患者(矽肺组)为研究对象,收集患者的痰标本,分别进行结核分枝杆菌痰涂片检查和BACTEC-MGIT 960培养,并对培养阳性的结核分枝杆菌菌株作一线抗结核药物的药敏分析。结果矽肺结核组患者痰涂片检查和BACTEC-MGIT 960培养的阳性率均高于矽肺组(47.2%vs 0.0%,67.7%vs 5.7%,P<0.01);矽肺结核组患者BACTEC-MGIT 960培养的阳性率高于同组患者的痰涂片检查阳性率(67.7%vs 47.2%,P<0.01)。180例患者痰标本经BACTEC-MGIT 960培养检出结核分枝杆菌阳性者共89株,该89株分离株均对一线抗结核药物耐药,总耐药率为100.0%,耐多药率为28.0%。耐药顺序从高到低依次为异烟肼、链霉素、乙胺丁醇和利福平。结论矽肺患者标本中分离出的结核分枝杆菌对抗结核药物呈现较高的耐药率,对矽肺患者定期进行结核分枝杆菌感染的检查是防治耐药结核分枝杆菌菌株传播的有效措施。
Objective To analyze the mycobacterium tuberculosis（ MTB） clinical test results and drug susceptibility tests of isolated strains in patients with silicosis. Methods The sputum samples of 127 patients clinically diagnosed as silicotuberculosis（ silicotuberculosis group） from October 2011 to October 2013 and sputum samples of 53 silicosis patients without tuberculosis（ silicosis group） were detected by sputum smear for MTB examination and BACTEC-MGIT 960 liquid culture,and the positive stains were further performed for drug susceptibility test by MGIT 960 method. Results The positive rates of sputum smear and BACTEC-MGIT 960 liquid culture in the silicotuberculosis group were significantly higher than those in the silicosis group（ 47. 2% vs 0. 0%,67. 7% vs 5. 7%,P〈0. 01）. The positive rate of BACTECMGIT 960 liquid culture in the silicotuberculosis group was significantly higher than the positive rate of sputum smear in the same group（ 67. 7% vs 47. 2%,P〈0. 01）. Eighty-nine MTB positive isolated strains of sputum specimen from the 180 cases were checked out by BACTEC-MGIT 960 liquid culture,and they were all resistant to first-line anti-tuberculosis drugs. The total drug resistant rate was 100. 0%,while the multi-drug resistant rate was 28. 1%. The drug-resistant rates from high to low were isoniazid,streptomycin,ethambutol and rifampin. Conclusion The isolated MTB from the sputum specimens in silicosis patients has higher drug resistance rate to anti-tuberculosis drugs,and regular check of MTB in silicosis patients is an effective measure to prevent and control the spread of drug-resistant tuberculosis strains.
出处
《中国职业医学》
CAS
北大核心
2015年第1期46-48,共3页
China Occupational Medicine
关键词
矽肺
矽肺结核
痰涂片
结核分枝杆菌
痰培养
抗结核药物
药敏试验
Silicosis
Silicotuberculosis
Sputum smear
Mycobacterium tuberculosis
Sputum culture
Antituberculosisdrug
Drug sensititve test
