OBJECTIVE:To improve evidence-based care in the management of tuberculosis, we retrospectively analyzed the bacterial types and drug sensitivity test results of mycobacteria in Guangzhou over the past twelve years (from July 1998 to March 2010).METHODS:Over these twelve years, a total of 14 095 mycobacterial strains isolated from different samples were subjected to type identification and drug sensitivity tests according to the Standard Protocols of Laboratory Diagnostics for Tuberculosis by the Chinese Antituberculosis Association. Chi-square test was performed for statistical analyses for comparisons between groups.RESULTS:Of 14 095 strains of mycobacteria isolated, 10 844 strains (76.84%) were MTB, and 3251 strains (23.16%) were non-tuberculosis mycobacteria (NTM). Compared with the result of the fourth national survey of tuberculosis epidemiology, which showed 11.1% of NTM, the one of our study was significantly different (χ(2) = 69.79, P < 0.001). Drug sensitivity tests of MTB showed tolerance rates of 28.99% (2729/9413), 21.75% (2047/9413), 17.45% (1643/9413) and 11.53% (1085/9413) against isoniazid, rifampin, streptomycin and ethambutol, respectively.CONCLUSION:An increasing trend was observed in MTB drug tolerance against streptomycin, rifampin and isoniazid, whereas more and more NTM strains were isolated in recent years. These findings are worthy of note for clinicians.

Objective To perform epidemiological study on tuberculosis in Guangzhou and to provide scientific basis for making proper measures for the prevention and control of tuberculosis. Methods Method of random sampling in the whole group of the 6 inspected spots was used in this study. The professional investigation teams were organized to carry out the relevant investigation. Tuberculin , X-ray and the tubercular bacteriain sputum were used in the diagnosis of TB. Basic questions, including the knowledge on the disease prevention,symptom, route of transmission and the therapeutic measure, were included in the questionnaire. Results A total of 10,923 subjects were studied. 22 cases of active pulmonary tuberculosis and 2 cases of infectious pulmonary tuberculosis were found. The morbidity rate was 201.41 / 105. The sputum-positive rate was 18.31 / 105. Awareness rate of knowledge on tuberculosis prevention and control was 52.5%. Conclusion There was a tendency of increase in tuberculosis in the town of Guangzhou. Health education should be given particularly to the female subjects, adolescent, elderly and individuals with low education level.

目的对医院内不同实验室或同一实验室不同生化检测系统检测结果进行比对分析和偏差评估,实现医院内不同生化检测系统检测结果一致性。方法参考美国临床实验室标准化委员会(NC-CLS)的EP15-A文件,以Roch Modular P800检测系统(S)为目标检测系统,Roch COBAS 400检测系统(1、2)、CL8000检测系统(3)为实验检测系统,检测患者血清TBIL、ALT、AST含量,进行比对研究和统计学分析,计算偏倚(SE%),实验检测系统比对项目取偏倚最高者与1/4CLIA'88允许误差进行比较,偏倚(SE%)小于等于1/4CLIA'88允许总误差(TBIL、ALT、AST1/4CLIA'88允许总误差均为5%),达到该项目院内检测结果一致性目的。结果①用原校准品校准各检测系统进行比对分析,TBIL、ALT、AST偏倚(SE%)分别为5.6%、19.2%、5.3%②采用目标检测系统定值的新鲜患者混合血清作为临时校准物校准各实验检测系统,第一次比对结果TBIL、ALT、AST偏倚(SE%)分别为5.3%、7.5%、4.7%;第二次比对结果TBIL、ALT、AST偏倚(SE%)分别为4.0%、4.1%、3.6%,实验检测系统比对项目SE%均小于5%,检测结果达院内一致性要求。结论采用目标检测系统定值的患者新鲜混合血清作为临时校准物,校准各实验检测系统的比对分析是实现医院内不同生化检测系统检测结果一致性的有效途径。

OBJECTIVE To understand nosocomial candidal infection among tuberculosis patients and its drug(sensitivity).(METHODS) Totally 6280 clinical samples from Jan 2002 to Dec 2004 were cultured;and part of(positive) ones were tested their drug sensitivity to FC,FLC,KET and ITC.RESULTS From all cultured samples 2767 Candida strains(positive rate was 44.06%) were isolated.From them C.albicans,C.glabrata,C.tropicalis,C.krusei and other Candida were 2006, 344,206,95 and 116 strains,their positive rate was 31.94%,(5.48%),3.28%, 1.51% and 1.85%,respectively.Their drug sensitivity rate to four drugs were as follows: to FC was 93.73%,to TTC 62.76%,to FLC 51.03% and to KET was 47.59%. CONCLUSIONS The condition of(tuberculosis) patient would become serious due to higher dual infection rate by Candida after too long anti-(tuberculosis) treatment.Among the four kinds of drugs the FC has the best anti-candidal activity.

目的了解和比较L-J法、Bactec法和BacT/ALERT 3D法等三种培养分支杆菌方法的各自优缺点.方法对临床送检的1 285份样本(包括978份结核病标本,307份非结核病标本),用前述三种方法进行分支杆菌的培养,其培养方法均各按有关文献进行.结果978份结核病患者标本中,三者的分离率分别依次为27.9%(27 3/978)、39.9%(391/978)和38.8%(379/978).其中非结核分支杆菌的分离率分别为:12.1%(33/273)、17.9%(70/391)和17.9%(68/379);而307份非结核病患者的标本中,Bactec法有4例出现假阳性,其他二者均没有出现;污染率则分别为2.6%(34/1285)、4.8%(62/128 5)和4.3%(55/1285);此外,初分离、药物敏感性试验和菌型鉴定所需天数,三者依次为:28.3d、21.7d、18.5d和13.3d、11.6d、5.4d以及16.8d、13.7d、6.9d;结论L-J法的污染率,远比后两者要低,但其阳性率和初分离、药物敏感性试验以及菌型鉴定所需天数,均远远逊色于后两者;而Bactec法与BacT/ALErT 3D法相比,则前者在上述的四方面要比后者稍胜一筹.但Bactec法存在放射性物质污染的危险.