肺结核并糖尿病首次复治患者结核分支杆菌的耐药分析.docVIP

精品论文 参考文献 肺结核并糖尿病首次复治患者结核分支杆菌的耐药分析 段新亚1 席秀红2（1、昆明市第三人民医院 结核一科 650041 云南 昆明；2、上海复旦大学附属公共卫生临床中心 结核科 01500 上海） 　　【摘要】目的：探讨肺结核合并糖尿病复治住院患者结核菌耐药性特征。方法：采用液体培养基Middlebrook 7H9 培养基干粉( 德国公司产品) 购自BD 公司；快速培养仪做痰结核菌耐药性及药敏试验。结果：收集2013 年1 月至2015 年12 月我科肺结核住院首次复治患者痰培养阳性并有明确药物敏感试验结果的患者，共1088 例。S，H，R，Z，E 耐药率分别为 27.9％，30.1％，13.7％和7.4％和5.2％。同时耐异烟肼加（R,Z,E,S）及链霉素加（H,R,Z,E）任何一种首次复治肺结核合并糖尿病患者的耐药性患者占31.8％，耐三种及三种以上的广泛耐药的首次复治肺结核合并糖尿病患者耐药率为11.1％。结论：首次复治肺结核患者中合并糖尿病的耐药性明显高于单纯复治肺结核患者。无论单独耐一种药还是耐二种及三种以上耐多药首次复治肺结核合并糖尿病患者的耐药率高于单纯首次复治肺结核患者，无论是否合并有糖尿病首次复治肺结核患者的耐药顺序从高到低依次归纳为：H、S、R、Z、E。发现耐二种及三种以上耐多药发生率低于单独耐一种药。 　　【关键词】首次复治肺结核；糖尿病；耐药性【中图分类号】 R2 【文献标号】 A 【文章编号】 2095-9753（2016）5-0274-02Drug resistance of mycobacterium tuberculosis in first retreatment of pulmonary tuberculosis(TB) complicated with diabetesmellitus patients DUAN Xin-ya，First Department of Tuberculosis，the Third Peoplersquo;s Hospital of Kunming，Kunming，Yunnan 650041，China[Abstract] Objective To evaluate characteristics of drug resistance in first retreatment of pulmonary tuberculosis(TB)complicated with diabetes mellitus patients. Methods Positive sputum specimens from first retreatment of pulmonary tuberculosis(TB)patients in our department were cultured by liquid medium Middlebrook, media 7H9( made in German, bought from BD company) ,thendrug susceptibility testing and drug resistance were done by rapid culture system . Results 1088 positive sputum patients weredivided into two groups according to whether complicating with diabetes mellitus, collected from January 2013 to December 2015.The total single drug resistant rate of S(streptomycin),H(isoniazid,INH),R(rifampicin,RFP),Z(pyrazinamide),E(ethambutol) were 27.9％ ,30.1％ , 13.7％ , 7.4％ and 5.2％ ,respectively. TB complicated with diabetes mellitus patients on two Anti-tuberculosis drug resistanceto H plus ( R, Z, E, S ) and S plus ( H, R, Z, E ) were 31.8%, multidrug resistant rate and extensively drug resistant rates were 11.1%.Conclusions The drug resistance rate in first retreatment of