| 林利,许河南,赖聪娟,张尊敬,郭净,丰银平,刘忠达.丽水市老年非结核分枝杆菌菌种分布及耐药情况分析[J].浙江中西医结合杂志,2026,36(2): |
| 丽水市老年非结核分枝杆菌菌种分布及耐药情况分析 |
| Analysis of the species distribution and drug resistance of nontuberculous mycobacteria in elderly patients in Lishui City |
| 投稿时间：2025-05-14 修订日期：2025-07-21 |
| DOI： |
| 中文关键词: 非结核分枝杆菌 老年人 菌种分布 耐药性 |
| 英文关键词:Nontuberculous Mycobacteria Elderly Species Distribution Drug Resistance |
| 基金项目:丽水市科技计划项目(2023GYX52)；丽水市科技计划项目(2018zdhz10)； |
|
| 摘要点击次数: 53 |
| 全文下载次数: 3 |
| 中文摘要: |
| 目的:分析丽水市老年(≥60岁)非结核分枝杆菌(NTM)肺病病原菌分布及耐药特征,为精准防控提供依据。方法:收集2022年-2024年丽水市结核病定点医院分离培养自疑似老年NTM肺病患者分枝杆菌临床分离株,经基因芯片法菌种鉴定,采用微量肉汤稀释法检测16种抗菌药物耐药性。结果:老年NTM肺病患者总检出率为19.31%(129/668)；年检出率从2022年14.75%上升至2024年22.55%(χ2趋势=4.152,P=0.042)。女性检出率35.93%(60/167)显著高于男性13.77%(69/501),(c2=39.457,P＜0.001)；菌群以胞内分枝杆菌75.19%(97/129)、鸟分枝杆菌12.40%(16/129)和龟/脓肿分枝杆菌6.98%(9/129)为主；对临床常用抗菌药物普遍存在高水平耐药,其中亚胺培南94.85%(92/97)、美罗培南93.81%(91/97)、阿莫西林/克拉维酸93.81%(91/97)；对多西环素、头孢西丁和利福平等亦呈现广泛耐药。且不同菌种耐药谱差异显著。结论:丽水市老年NTM肺病发病率呈逐年上升趋势,病原菌分布存在地域特征及性别差异,耐药问题突出。建议建立区域性NTM菌种库,结合药敏监测实施个体化治疗,以应对NTM感染的公共卫生挑战。 |
| 英文摘要: |
| Objective: To analyze the distribution and drug resistance profiles of non-tuberculous mycobacteria (NTM) in elderly patients (≥60 years) with NTM pulmonary disease in Lishui, in order to provide evidence for precision prevention and control strategies. Methods: From 2022 to 2024, clinical NTM isolates were collected from suspected elderly NTM pulmonary disease patients at designated tuberculosis hospitals in Lishui. Species identification was performed using gene chip technology, and drug susceptibility testing for 16 antimicrobial agents was conducted using the broth microdilution method. Results: The overall detection rate among elderly NTM pulmonary disease patients was 19.31% (129/668), showing a significant annual increase from 14.75% in 2022 to 22.55% in 2024 (χ2trend=4.152, P=0.042). Gender disparity was notable with higher detection rates in females (35.93%, 60/167) compared to males (13.77%, 69/501) (χ2=39.457, P<0.001). Predominant pathogens included Mycobacterium intracellulare (75.19%, 97/129), Mycobacterium avium (12.40%, 16/129), and Mycobacterium chelonae/abscessus complex (6.98%, 9/129). High-level resistance was observed against first-line antimicrobials: imipenem (94.85%, 92/97), meropenem (93.81%, 91/97), and amoxicillin/clavulanate (93.81%, 91/97). Extensive resistance also emerged against doxycycline, cefoxitin, and rifampicin, with significant interspecies variation in resistance profiles. ?Conclusions: Lishui City demonstrates an escalating incidence of NTM pulmonary disease among elderly populations, characterized by distinct geographical pathogen distribution and gender-specific epidemiological patterns, compounded by severe multidrug resistance. Establishment of regional NTM strain repositories and implementation of personalized treatment guided by antimicrobial susceptibility testing are recommended to address this public health challenge. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
