临床内科杂志 ›› 2019, Vol. 36 ›› Issue (11): 733-735.doi: 10.3969/j.issn.1001-9057.2019.11.005

• 论 著 • 上一篇    下一篇

2006~2015年上海市公共卫生临床中心艾滋病患者的分枝杆菌培养阳性结果分析

  

  • 出版日期:2019-11-15 发布日期:2019-11-30
  • 基金资助:
    国家“十三五”重大新药创制专项(2017ZX09304027)

Analysis of the positive results of mycobacterium culture detection among AIDS patients in Shanghai Public Health Clinical Center from 2006 to 2015

  • Online:2019-11-15 Published:2019-11-30

摘要: 目的 分析2006年~2015年上海市公共卫生临床中心病原培养分枝杆菌阳性的艾滋病患者结核分枝杆菌(MTB)与非结核分枝杆菌(NTM)的构成及耐药情况。方法 收集2006年1月~2015年12月入住我院且存在临床相应感染症状并具有分枝杆菌培养阳性结果的艾滋病患者816例,收集其年龄、性别等一般资料、耐药检测和NTM分型结果并进行分析。结果 816例分枝杆菌感染患者中男679例,女137例,中位年龄40岁。MTB感染患者364例(44.6%),NTM感染患者377例(46.2%)。判定为MTB感染且有耐药检测资料患者共275例,对链霉素及异烟肼的耐药率均为24.0%(66例),对乙胺丁醇的耐药率为17.1%(47例),对利福平的耐药率为16.7%(46例);耐多药结核病为42例(15.3%)。判定为NTM感染且有耐药检测资料患者共124例,对异烟肼的耐药率为91.1%(113例),对链霉素的耐药率为83.9%(104例),对利福平的耐药率为47.6%(59例),对乙胺丁醇的耐药率38.7%(48例)。共102例NTM患者有分型资料,其中鸟-胞内分枝杆菌33例(32.3%),戈登分枝杆菌29例(28.4%),堪萨斯分枝杆菌25例(24.5%)。结论 对于分枝杆菌培养结果阳性的艾滋病患者,NTM比例明显高于普通人群,治疗上需根据药物敏感试验结果适当调整用药。

关键词: 人免疫缺陷病毒; 艾滋病; 分枝杆菌; 结核分枝杆菌; 非结核分枝杆菌

Abstract: Objective To analyze the distribution and drug resistance of mycobacterium tuberculosis(MTB) and non-tuberculosis mycobacteriu(NTM) among AIDS patients with positive results of mycobacterium culture in Shanghai public health clinical center from 2006 to 2015.Methods From January 2006 to December 2015,the patients who were admitted to our hospital with clinical symptoms and positive results of mycobacterium culture were collected.The general data such as age and gender,the results of subsequent drug resistance test and NTM typing results were collected and analyzed.Results In 816 cases with mycobacterium,679 cases were male and 137 cases were female.The median age was 40 years.There were 364 patients(44.6%) infected with MTB and 377 patients(46.2%) with NTM.There were 275 cases with MTB infection and drug resistance test data.The drug resistance rates to streptomycin and isoniazid were 24.0%(66 cases) respectively,the drup resistance rate to ethambutol was 17.1%(47 cases),and the drug resistance rate to rifampicin was 16.7%( 46 cases);42 cases(15.3%) were multi-drug resistant tuberculosis.There were 124 patients with NTM infection and drug resistance test data.The resistance rate to isoniazid was 91.1%(113 cases),and the resistance rate to streptomycin was 83.9%(104 cases).The drug resistance rate to rifampicin was 47.6%(59 cases),and the drug resistance rate to ethambutol was 38.7%(48 cases).A total of 102 NTM typing data were collected,including 33 cases(32.3%) of mycobacterium avium,29 cases(28.4%) of mycobacterium Gordon and 25 cases(24.5%) of mycobacterium Kansas.Conclusion For AIDS patients with mycobacterium infection,the proportion of NTM is significantly higher than that of the general population without HIV infection,so it is necessary to adjust the regimen according to the results of drug sensitivity test.

Key words: Human Immunodeficiency Virus; Acquired immunodeficiency syndrome; Mycobacterium; Mycobacterium tuberculosis; Nontuberculosis Mycobacteria