矽肺患者结核分枝杆菌临床分离培养与抗结核药物敏感检测

发布时间：2018-02-16 00:30

本文关键词： 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　出处：《中国职业医学》2015年01期 　论文类型：期刊论文

【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%,P0.01);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%,P0.01)。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。
[Abstract]:Objective to analyze the clinical results of Mycobacterium tuberculosis in silicosis patients. Methods from October 2011 to October 2013, 127 cases of silicosis complicated with pulmonary tuberculosis (silicosis group) and 53 cases of silicosis without pulmonary tuberculosis (silicosis group) were studied. The sputum samples of the patients were collected, and the sputum smears of Mycobacterium tuberculosis and BACTEC-MGIT 960 culture were performed respectively. Results the positive rates of sputum smear examination and BACTEC-MGIT 960 culture in patients with silicotuberculosis were higher than those in silicosis group (47.2 vs 0.067.7 vs 5.7P 0.01) and BACTEC-MGIT 960 in silicosis patients. The positive rate of culture was higher than that of sputum smear examination in the same group (67.7 vs 47.2). 89 strains of Mycobacterium tuberculosis were detected by BACTEC-MGIT 960 culture. All the 89 strains were resistant to first-line anti-tuberculosis drugs, the total drug resistance rate was 100.0and the multidrug resistance rate was 28.0.The sequence of drug resistance was isoniazid, streptomycin, isoniazid, streptomycin, and isoniazid, streptomycin, isoniazid and streptomycin. Conclusion Mycobacterium tuberculosis isolated from patients with silicosis has a high drug resistance rate. Periodic examination of mycobacterium tuberculosis infection in silicosis patients is an effective measure to prevent and cure the spread of drug-resistant mycobacterium tuberculosis.
【作者单位】：郑州铁路职业技术学院医学技术系;河南省胸科医院;河南省职业病防治研究院;
【分类号】：R135.2;R521

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