北臺灣結核菌抗藥性試驗現況分析

Current Status of Drug Resistance of Mycobacterium Tuberculosis in Northern Taiwan

郭金龍(King-Lung Kuo) ； 魏秋芳(Chiou-Fang Wei)

《北市醫學雜誌》 4卷4期 (2007/04) Pp. 294-301

https://doi.org/10.6200/TCMJ.2007.4.4.05

摘要

目的：評估結核菌的抗藥性現況。方法：本研究以回溯性方法蒐集本院區今年痰液培養所分離之結核菌的藥敏試驗抗藥性情況，以傳統間接比例法及採用瓊脂紙錠釋出方法進行分枝桿菌藥敏試驗之檢驗，共計2657病患菌株，分析其對抗結核藥物的抗藥性比例。結果：分枝桿菌培養陽性共2657菌株/人，其中1848株(69.55%)為結核分枝桿菌，809株(30.45%)為非典型結核分枝桿菌感染。1848株結核分枝桿菌中，337株(18.24%)有抗藥性問題，其中75株(4.06%)同時對Isoniazid和Rifampin有抗藥性為多重性抗藥菌(MDR)。548株非典型結核分枝桿菌(NTM)中453株(82.66%)有抗藥性問題；快速生長菌群共261株，其中242株(92.72%)有抗藥性問題。結論：研究分析結果顯示台北市立聯合醫院疾病管制院區所培養分離的菌株中結核分枝桿菌多重性抗藥菌比例達4.06%，但非典型結核分枝桿菌抗藥性之菌株比例卻非常的高，值得密切的注意。

關鍵字

結核菌 ； 藥物敏感試驗 ； 多重性抗藥菌

並列摘要

Background & Purpose: To evaluate the current status of drug resistant tuberculosis. Methods: We retrospectively collected the drug sensitivity test results of tuberculosis cultures from sputum in our department during 2005, using the Proportion method and the Disk method to perform the drug sensitivity tests. In total, 2657 strains isolated from patients were evaluated and the percentages of drug resistant strains were analyzed. Results: Cultures for Mycobacterium were positive in a total of 2657 people, among them 1848 strains (69.55%) were Mycobacterium tuberculosis, and 809 strains (30.45%) were Nontuberculous Mycobacterium (NTM). Among the 1848 strains of Mycobacterium tuberculosis, 337 strains (18.24%) were drug resistant, and 75 strains (4.06%) of them were resistant to both Isoniazid and Rifampin which made them multi-drug resistant (MDR). Among the 548 strains of Nontuberculous Mycobacterium, 453 strains (82.66%) were drug resistant. There were a total of 261 rapidly growing mycobacteria, and 242 (92.72%) of them were drug resistant. Conclusion: We concluded that sputum cultures in the Taipei Hospital Branches for Communicable Disease Control revealed that 4.06% were multi-drug resistant strains of Mycobacterium tuberculosis and a very high percentage of multi-drug resistance in Nontuberculous Mycobacterium, which requires the attention of health workers.

並列關鍵字

Tuberculosis ； drug sensitivity test ； multi-drug resistance