\t\t\t\t\t 目的 \t\t\t\t\t了解本地区结核分枝杆菌耐药状况, 为选择有效抗生素阿莫西林/克拉维酸钾敏感性提供有效数据。\t\t\t\t\t 方法 \t\t\t\t\t对本地区筛选初诊痰涂片阳性病人在抗痨前取痰接种于酸性罗氏培养基培分离结核分枝杆菌, 用快速药敏试剂盒进行药敏试验及阿莫西林/克拉维酸钾最低抑菌浓度(MIC)测定。\t\t\t\t\t 结果 \t\t\t\t\t158例药敏试验中, 结核分枝杆菌总耐药率56.3%。符合本项目选项多耐31.6%(50/158), 其中耐I+R8%, I+R+S12%, I+R+E10%, I+R+P4%, I+S+E+P26%, R+S+E+P6%, Z+R+S+E+P 34%。阿莫西林/克拉维酸钾MIC2/1, 1/0.5, 05/0.25, 0.25/0.125, 0.125/0.06 25(μg/ml)分别占2%, 2%, 2.2%, 5.8%, 16%。表明阿莫西林/克拉维酸钾对多耐结核分枝杆菌有显著疗效, 绝大部分小剂量(0.25 μg/ml左右)就可产生效果。\t\t\t\t\t 结论 \t\t\t\t\t本地区结核病人耐药趋向多种较高水平耐药, 而利用新药有较好疗效, 对指导临床治疗有意义。
\t\t\t\t\t Objective \t\t\t\t\tTo observe the prevalence stature of drug-resistance to mycobacterium tuberculosis and to provide the data of drug susceptibility for selecting effective antibiotics-Amoxicillin/potassium clavulanate.\t\t\t\t\t Methods \t\t\t\t\tTo collect the sputum smear-position patients in our ocal community and to get the sputum samples before the treatment with antituberculosis agents, than the samples were inoculated on Lowenstein-Jensen culture medium for isolating mycobacterium tuberculosis.The drug susecptibility test and miniumum inhibitor concentration(MICs)testing of Amoxicillin/potassium clavulaate were performed with the rapid drup susceptibility KIT.\t\t\t\t\t Results \t\t\t\t\tAmong the 158 test of drug susceptibility, the total drug-resistant rate to mycobacterium tuberculosis was 56.3%, 31.6%(50/158)of all samples were accorded with multidrug-resistant standards in this study.INH-and RFP-resistant rate was 8%.12% INH-, RFP-, and SM-resistance.10% for INH-, RFP-and EBresistance.4% for INH-, RFP-and PZA-resistance.26% for INH-, RFP-and PZA-resistance.61 RFP-, SM-, EB-and PZAresistance.26% for INH-, SM-EB-and PZA-resistance.6% for RFP-, SM-, EB-and PZA-resistance and 34% for INN-, RFP-, SM-, EB-and PZA-resistance.MICs of Amox icillin/potassium clavulanate with 2.0/1.0, 1.0/0.5, 0.5/0.25, 0.25/0.125 and 0.125/0.0625(μg/ml)were 2%, 2%, 22%, 58% and 16% respectively.Amoxicillin/potassium clavulanate had the significant curative effect to multi-resistant mycobacterium tuberculosis.And in the great majority of tests, at the low dose (0.25 μg/ml)so much might do the deed.\t\t\t\t\t Conclusion \t\t\t\t\tDrug-resistance of the tuber culosis patients in our local community trended to multidrug-resistance at a higher level.And applying the new drug had better curative effect and made sense to direct the clinical treatment.
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