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预防医学  2021, Vol. 33 Issue (1): 6-10    DOI: 10.19485/j.cnki.issn2096-5087.2021.01.002
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浙江省非结核分枝杆菌流行状况及耐药性分析
朱业蕾, 潘爱珍, 周琳, 柳正卫, 张明五, 吴坤阳, 王晓萌, 吴蓓蓓
浙江省疾病预防控制中心结核病预防控制所,浙江 杭州 310051
Prevalence and drug resistance of nontuberculous mycobacteriain Zhejiang Province
ZHU Yelei, PAN Aizhen, ZHOU Lin, LIU Zhengwei, ZHANG Mingwu, WU Kunyang, WANG Xiaomeng, WU Beibei
Department for Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control andPrevention, Hangzhou, Zhejiang 310051, China
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摘要 目的 分析浙江省非结核分枝杆菌(NTM)的流行状况及耐药性,为防制NTM病提供依据。方法 对浙江省2008年度、2013年度和2018年度3次耐药监测收集的2 878株分枝杆菌分离株采用PNB/TCH生长试验进行初步鉴定,分别用16SrRNA、rpoB、ITS、hsp65基因测序方法进行菌种鉴定。采用比例法药物敏感性试验检测NTM菌株对抗结核药物的耐药性。结果 2 878株分枝杆菌分离株中有135株最终鉴定为NTM,分离率为4.69%。2008年度、2013年度和2018年度耐药检测NTM分离率分别为1.85%、4.56%和7.84%,呈上升趋势(P<0.05)。共13种NTM,以胞内分枝杆菌为主,82株占60.74%;其次为堪萨斯分枝杆菌,18株占13.33%。NTM对异烟肼、氨基水杨酸和链霉素耐药率较高,分别为97.78%、94.87%和94.81%。结论 浙江省2008年度、2013年度和2018年度3次耐药监测NTM分离率呈上升趋势,胞内分枝杆菌、堪萨斯分枝杆菌为主要菌种,NTM对一、二线抗结核药物均有较高的耐药性。
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朱业蕾
潘爱珍
周琳
柳正卫
张明五
吴坤阳
王晓萌
吴蓓蓓
关键词 非结核分枝杆菌菌种鉴定耐药性    
AbstractObjective To learn the prevalence and drug resistance of nontuberculous mycobacteria ( NTM ) in Zhejiang Province, so as to provide evidence for NTM prevention and control. Methods A total of 2 878 clinical mycobacterium isolates in Zhejiang Province were collected from the drug resistance surveillance in 2008-2009, 2013-2014 and 2018-2019, PNB/TCH growth tests were used to preliminarily identify the NTM in these mycobacterium-positive isolates. 16SrRNA, rpoB, ITS and hsp65 gene sequencing analysis were used to confirm strains initially identified as NTM. Proportional method was applied to detect drug susceptibility of NTM isolates. Results Finally, 135 strains were confirmed as NTM and the isolation rate was 4.69%. The isolation rates of NTM in 2008-2009, 2013-2014 and 2018-2019 were 1.85%, 4.56% and 7.84%, respectively, with an increasing trend ( P<0.05 ). Thirteen species were identified and the top two species were M. intracellulare ( 82, 60.74% ) and M. kansassi ( 18, 13.33% ). The NTM isolates showed the highest drug resistance rate to isoniazid ( 97.78% ), followed by p-aminosalicylic acid ( 94.87% ) and streptomycin ( 94.81% ). Conclusions The isolation rates of NTM showed an upward trend in the drug resistance surveillance in 2008-2019,2013-2014 and 2018-2019 in Zhejiang Province. M. intracellulare and M. kansassi were the main strains isolated. The NTM isolates showed high resistance against both first and second-line antituberculosis drugs.
Key wordsnontuberculous mycobacteria    species identification    drug resistance
收稿日期: 2020-08-07      出版日期: 2021-01-14
ZTFLH:  R446.5  
基金资助:国家“十三五”“艾滋病和病毒性肝炎等重大传染病防治”重大专项课题(2018ZX10103001); 浙江省医药卫生科技计划项目(2017KY284); 浙江省疾病预防控制中心青年科技创新人才培养项目
通信作者: 吴蓓蓓,E-mail:bbwu@cdc.zj.cn   
作者简介: 朱业蕾,硕士,技师,主要从事结核病防治实验室检测工作
引用本文:   
朱业蕾, 潘爱珍, 周琳, 柳正卫, 张明五, 吴坤阳, 王晓萌, 吴蓓蓓. 浙江省非结核分枝杆菌流行状况及耐药性分析[J]. 预防医学, 2021, 33(1): 6-10.
ZHU Yelei, PAN Aizhen, ZHOU Lin, LIU Zhengwei, ZHANG Mingwu, WU Kunyang, WANG Xiaomeng, WU Beibei. Prevalence and drug resistance of nontuberculous mycobacteriain Zhejiang Province. Preventive Medicine, 2021, 33(1): 6-10.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2021.01.002      或      http://www.zjyfyxzz.com/CN/Y2021/V33/I1/6
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