中部某區域醫院以TB培養方式分析結核分枝桿菌陽性率及抗藥性

Analysis of Mycobacterium Tuberculosis Complex Positive rate and drug Resistance Using Tuberculosis Cultures at a Regional Hospital in Central Taiwan

目的：分枝桿菌是由結核分枝桿菌（Mycobacterium tuberculosis complex, MTBC）與非結核分枝桿菌（Nontuberculous Mycobacteria, NTM）所組成；在分枝桿菌屬中最重要的當屬結核分枝桿菌，它是造成結核病的病原菌。因此，我們收集2013年至2018年TB培養的結果，分析陽性率，並針對分離的513株結核分枝桿菌之藥物敏感性及流行病學作近一步探討分析。方法：本研究以中部某區域醫院於2013年1月至2018年12月分離的513株結核分枝桿菌的之流行病學資料為基礎，再以瓊脂平版法（Agar Proportion Method）測試來判讀這513株菌株的藥物敏感性。結果：513株結核分枝桿菌之病人資料分析：分析陽性病人年齡層以71-80歲最多，有108位（21.1％），其次是81-90歲，有95位（18.5％），41-50歲，有78位（15.2％）；性別方面男生有364人（佔71％），女性有149人（佔29％）；檢體來源主要是以Sputum有473（92.1％），Pus有10（1.9％），Pleural Effusion有9（1.8％）分離為主。2013年至2018年分枝桿菌培養陽性率為9.2-11.9％，結核分枝桿菌培養平均陽性率約有4.9％。結論：2013年至2018年分枝桿菌培養陽性率為9.2- 11.9％，結核分枝桿菌培養平均陽性率約有4.9％。統計2013年至2018年結核分枝桿菌藥敏試驗的結果中發現，結核分枝桿菌對目前的第一線用藥：Rifampin（RA）、Ethambutol（EMB）、Isoniazid（INH）、Streptomycin（S）大多呈高度感受性。（澄清醫護管理雜誌2020；16（3）：23-28）

Purposes: Mycobacteria comprise the Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM). The most important of the mycobacteria is Mycobacterium tuberculosis, which is the causative agent of tuberculosis. Thus, we collected tuberculosis culture results between 2013 and 2018, analyzed the positive rate, and further investigated and analyzed the drug sensitivity and epidemiology of M. tuberculosis strains isolated from 513 patients. Methods: This study was based on epidemiological data of M. tuberculosis strains isolated from 513 patients at a regional hospital in central Taiwan between January 2013 and December 2018. The drug sensitivities of the strains were investigated using the agar proportion method. Results: Analysis of the data from the 513 patients showed that the highest proportion of M. tuberculosis-positive patients were aged 71-80 years (108 cases, 21.1%), followed by 81-90 years (95 cases, 18.5%) and 41-50 years (78 cases, 15.2%). There were 364 male (71%) and 149 female (29%) patients. The major sources of the specimens were sputum (473 cases, 92.1%), pus (10 cases, 1.9%), and pleural effusion (9 cases, 1.8%). Between 2013 and 2018, the mycobacterial positive culture rate was 9.2-11.9%, and the average MTBC positive culture rate was approximately 4.9%. Conclusions: Between 2013 and 2018, the mycobacterial positive culture rate was 9.2-11.9%, and the average MTBC positive culture rate was approximately 4.9%. According to the results of M. tuberculosis drug susceptibility testing between 2013 and 2018, M. tuberculosis was highly susceptible to the most current first-line drugs, including rifampin (RA), ethambutol (EMB), isoniazid (INH), and streptomycin (S). (Cheng Ching Medical Journal 2020; 16(3): 23-28)