2月末结核分枝杆菌阳性初治肺结核患者菌型鉴定结果分析

目的分析深圳市南山区2月末结核分枝杆菌阳性肺结核患者的分枝杆菌分布情况,为诊断与治疗分枝杆菌感染提供参考依据。方法 2013年1月至2015年12月深圳市南山区痰结核分枝杆菌阳性的初治肺结核患者治疗2月末仍结核分枝杆菌阳性患者进行菌型鉴定并进行结果分析。结果 617例结核分枝杆菌阳性肺结核患者经2个月强化期治疗后,46例患者出现2月末结核菌阳性,其中涂片阳性为33例,涂片阴性而培养阳性为13例;涂片阳性患者中19例培养阴性,10例为结核药物敏感菌,4例为非结核分枝杆菌;涂阴培阳患者中1例为结核药物敏感菌,12例为非结核分枝杆菌;16例非结核分枝杆菌经分型鉴定后,7例脓肿分枝杆菌,9例戈登分枝杆菌。结论肺结核患者可能继发非结核分枝杆菌感染,抗结核治疗2月末肺结核病人应及时留取痰标本做结核菌涂片,培养和菌种鉴定,为进一步诊断和制定个体化疗方案提供依据。

Analysis on the results of positive sputum in new positive sputum pulmonary tuberculosis after 2-month treat-ment

Objective To analyze the distribution of non-tuberculosis mycobacterium(NTM)and tuberculo-sis among the new sputum positive pulmonary tuberculosis patients after 2-month treatment. Methods The identifi-cation of bacteria were performed for patients with positive pulmonary TB after 2-month treatment from January 2011 to December 2015 in Nanshan Chronic Disease Control Center. Results 2 months after treatment,46 patients were with positive sputum mycobacterium from 617 new sputum positive pulmonary tuberculosis patients,including 33 smear-positive cases and 13 only culture-positive TB subjects. Among 33 smear positive patients,19 cases were culti-vates negative,10 cases were drug sensitive,and 4 were non tuberculous mycobacterium(NTM). Among 13 only culture positive patients,1 case was drug sensitive,and 12 cases were non tuberculous mycobacterium( NTM). there were 7 cases of mycobacterium abscessus and 9 cases of mycobacerium gordonae in 16 cases of non-tuberculous mycobacterium(NTM). Conclusion There is a situation of co-infection of NTM in patients with pulmonary TB. The patients,who are new sputum positive pulmonary tuberculosis after the 2-month treatment still sputum positive, should be given bacteria identification and drug sensitivity test.