目的 了解西安市胸科醫(yī)院結(jié)核分枝桿菌的耐藥情況,為臨床醫(yī)生調(diào)整治療方案和流行病學(xué)調(diào)查提供依據(jù)。方法 選取2013年1月—2015年11月西安市胸科醫(yī)院結(jié)核分枝桿菌感染的住院患者392例,對分離出的病原菌的耐藥性進行分析。結(jié)果 菌株來源于132例初治患者和260例復(fù)治患者,其中男性患者多于女性患者,年齡段主要集中在36～55歲。初治耐藥率為22.5%,獲得性耐藥率為41.2%;鏈霉素的耐藥率最高,為23.7%,乙胺丁醇的耐藥率最低,為13.3%;單一耐藥菌株有60株,耐藥率為15.4%;多耐藥菌株有37株,耐藥率為9.4%;耐多藥的菌株有52株,耐藥率為13.2%;有27株全耐藥,耐藥率為6.9%。結(jié)論 西安市胸科醫(yī)院結(jié)核分枝桿菌的耐藥狀況仍處較高水平,應(yīng)做好結(jié)核分枝桿菌的培養(yǎng)和藥敏試驗,并根據(jù)藥敏實驗結(jié)果合理制定或調(diào)整治療方案。

Objective To investigate the drug resistance of Mycobacterium tuberculosis in Xi'an Chest Hospital, and to provide reference for clinicians to adjust the therapeutic schedule, and epidemiological investigation. Methods Inpatients (392 cases) with hospital acquired infection in Xi'an Chest Hospital from January 2013 to November 2015 were selected. The drug resistance of pathogenic bacteria was analyzed. Results Strains were obtained from initial patients (132 cases) and retreated patients (260 cases). In which male patients were more than female patients, and the ages of most patients were 36 to 55 years old. Initial drug resistant rate was 22.5%, and acquired resistance was 41.2%. The drug resistant rate of streptomycin was the highest, taking for 23.7%. While the drug resistant rate of ethambutol was the lowest, accounting for the percentages of 13.3%. There were 60, 37, 52, and 27 strains of single drug resistant strains, multiple drug resistant strains, multi-drug resistant strains, and all the drug-resistant strains. And the percentage was 15.4%, 9.4%, 13.2%, and 6.9%, respectively. Conclusion The drug resistance of M. tuberculosis in Xi'an Chest Hospital is still at a higher level, the cultivation of M. tuberculosis and drug susceptibility test should be well done, and the therapeutic schedule should be set reasonably or adjusted according to the results of drug sensitive experiment.