Samant Hrishikesh, Desai Devendra, Abraham Philip, Joshi Anand, Gupta Tarun, Rodrigues Camilla, George Siji
Division of Gastroenterology, P D Hinduja National Hospital and Medical Research Centre, Swatantrya Veer Savarkar Marg, Mahim West, Mumbai, 400 016, India.
Indian J Gastroenterol. 2014 Sep;33(5):414-9. doi: 10.1007/s12664-014-0467-x. Epub 2014 Jun 15.
Culture positivity for Mycobacterium tuberculosis complex (MTB) in abdominal tuberculosis (TB) using Lowenstein Jensen medium and Bactec system varies from 25 % to 36 %. Data on the prevalence of drug resistance in primary abdominal TB is scant. Our aim was to study the acid-fast bacilli (AFB) culture positivity rate in primary abdominal TB using Bactec Mycobacterial Growth Indicator Tubes (MGIT) system and the prevalence of drug resistance in these patients.
Records of patients with abdominal TB (diagnosed on clinical features, endoscopy, histology, microbiology) seen during the period 2008 to 2013 were retrieved from the Gastroenterology and Microbiology departments. Patients with extra-abdominal TB (five pulmonary, two nodal), adnexal (one), and HIV (one) were excluded from analysis.
Of 61 patients, 31 (50.8 %) had a positive AFB culture. In the 30 culture-negative patients, histology showed non-caseating granulomas in 25 patients. Drug sensitivity pattern was analyzed in 18 patients; resistance was detected in eight (14.3 % of all patients and 44.4 % of patients in whom drug sensitivity was done) including three (5.4 % of all subjects and 16.6 % in whom drug sensitivity was available) who were multidrug-resistant.
The rate of AFB culture positivity in primary abdominal TB was 50.8 % using Bactec MGIT. Likelihood of drug resistance was seen in 14.3 %, of whom 5.4 % were multidrug-resistant.
使用罗-琴培养基和Bactec系统检测腹部结核（TB）中结核分枝杆菌复合群（MTB）的培养阳性率在25%至36%之间。关于原发性腹部结核耐药性流行情况的数据很少。我们的目的是研究使用Bactec分枝杆菌生长指示管（MGIT）系统检测原发性腹部结核中抗酸杆菌（AFB）的培养阳性率以及这些患者的耐药性流行情况。
检索2008年至2013年期间在胃肠病学和微生物学科室就诊的腹部结核患者（根据临床特征、内镜检查、组织学、微生物学诊断）的记录。排除有腹部外结核（5例肺部、2例淋巴结）、附件结核（1例）和HIV感染（1例）的患者进行分析。
61例患者中，31例（50.8%）AFB培养阳性。在30例培养阴性的患者中，组织学检查显示25例有非干酪样肉芽肿。对18例患者进行了药敏模式分析；8例（占所有患者的14.3%，占进行药敏检测患者的44.4%）检测到耐药，其中3例（占所有受试者的5.4%，占可进行药敏检测患者的16.6%）为多重耐药。
使用Bactec MGIT检测原发性腹部结核中AFB培养阳性率为50.8%。耐药的可能性为14.3%，其中5.4%为多重耐药。
