分枝杆菌属中除结核分枝菌和麻风分枝菌外，还有许多具有抗酸染色特性的菌群。自1885年最早分离出耻垢分枝杆菌以来，迄今已发现百种以上，历来对此命名甚多，目前将除结核分枝杆菌复合群和麻风分枝杆菌之外的分枝杆菌统称为非结核分枝杆菌 （non-tuberculosismycobacterium, NTM）这个名称[1]。近年来，结核病的发病有上升趋势，难治、复治结核患者中，部分是非结核分枝杆菌引起的非结核分枝杆菌肺病，但常被医生疏忽。近年来，国外NTM病的发病率增加[2]，国内有NTM引起的肺病及医院感染屡有报道[3-5]。为了解西藏NTM菌株的耐药情况和NTM肺病的临床特点，我们对2008年3月至2010年7月在西藏疾病预防控制中心结核病实验室分离、培养的分枝杆菌培养物菌种鉴定、耐药性检测及其临床资料分析。
论著
西藏自治区非结核分枝杆菌耐药特点及临床特征初步分析
黄丽萍1 石荔1* 魏淑贞2 巴桑1 西洛1
【摘要】 目的 探讨西藏自治区非结核分枝杆菌（NTM）的耐药情况及临床特点。方法 收集2008年3月至2010年7月西藏自治区疾病预防控制中心结核病实验室从患者痰标本分离培养的分枝杆菌培养物，用PNB/TCH鉴别培养基培养进行菌种鉴定，采用WHO推荐的比例法进行4种一线药物异烟肼（INH）、利福平（RFP）、乙胺丁醇（EMB）和链霉素（SM）的药敏试验，并结合临床资料分析NTM病例的临床特征。
【关键字】 结核病,非结核分支杆菌,药物耐药性,临床症状
中图分类号：R52文献标识码：B文章编号：1671-8194（2011）01-0005-02
Preliminarily Analyse on the Characteristics of Drug Resistance and Clinical Symptoms of Non-Tuberculosis Mycobacterium Infection in Tibet
HUANG Li-ping1, SHI Li1, WEI Shu-zhen2, BA Sang1, XI Luo1
(1 The Tibet Autonomous Region People's Hospital, Lasha 850000,China; 2 Fujian Center for Disease Control and Prevention, Fuzhou 350001,China)
[Abstract] Objective To explore the drug resistant situation and clinical features of non- tuberculosis mycobacterium (NTM) infection in Tibet. Methods From March 2008 to July 2010, 412 strains isolated from sputum were identified and conducted drug susceptibility test in laboratory in Tibet Center for Disease Control and Prevention, and the clinical data of 18 patients infected with NTM were analyzed. Results 18 strains of NTM was identified from 412 strains of mycobacterium, occupied 4.4%. The drugs (INH, RFP, SM and EMB)resistant rate was 88.9%, 77.8%, 94.4% and 22.2% respectively. The multi-drug resistant rate was 77.8%,and the total rate of drugs resistantance was100%.The main symptoms of patients infected NTM were cough, expectoration, fever and haemoptysis and so on. And wide range of lung had pathological change when the patients infected NTM, which was more common in the middle-aged patients. Conclusions NTM also exist in Tibet autonomous region. NTM was resistant to INH, RFP and SM. And the treatment programs of lung disease by NTM is need to be regularized.