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〔目的〕了解2008年上海出入境人员结核病的实验室检测情况。〔方法〕对2008年上海口岸出入境人员检疫疾病监测过程中,胸片X射线检测怀疑活动性肺结核的患者进行痰液的抗酸染色检查、分支杆菌培养以及细菌鉴定。〔结果〕2008年1—12月上海地区出入境人员X射线检测怀疑活动性肺结核患者28人。痰涂片抗酸杆菌阳性的共5例(占17.86%),其中1～9条/100视野的3例,1～2条/300视野的2例。痰培养阳性16例,占57.14%;阴性12例,占43.86%;其中液体培养及LJ培养均为阳性9例;液体培养阴性、LJ培养阳性1例;液体培养阳性、LJ培养阴性6例。培养阳性的菌株中鉴定为结核分支杆菌复合群的为4例,占25.00%;鉴定为非结核分支杆菌(NTM)的为12例,占75.00%。经核酸测序显示NTM中,胃、堪萨斯分支杆菌2例,脓肿、龟分支杆菌8例,戈登分支杆菌1例,偶然分支杆菌1例。〔结论〕加强对出入境重点人群的结核病监测具有重要意义,同时实验室需要提高痰涂片的检出率,重视疾液培养技术,努力提高检测能力。
[Purpose] To understand the laboratory tests of tuberculosis in entry-exit personnel in Shanghai in 2008. [Methods] During the quarantine disease surveillance of exit-entry personnel at the Shanghai port in 2008, acid-fast staining of sputum, mycobacterial culture and bacterial identification were performed in patients with suspected active pulmonary tuberculosis by X-ray. [Results] From January to December 2008, 28 immigrants in Shanghai who were suspected of active pulmonary tuberculosis were detected by X-ray. Sputum smear acid-fast bacilli in a total of 5 cases (17.86%), of which 1 to 9/100 visual field in 3 cases, 1 to 2/300 field in 2 cases. The sputum culture positive in 16 cases, accounting for 57.14%; negative in 12 cases, accounting for 43.86%; liquid culture and LJ culture were positive in 9 cases; liquid culture negative, LJ culture positive in 1 case; liquid culture positive, LJ culture negative in 6 cases. Among the positive cultures, 4 were identified as Mycobacterium tuberculosis complex, accounting for 25.00%; 12 were identified as non-tuberculous mycobacteria (NTM), accounting for 75.00%. Nucleic acid sequencing showed NTM gastric, Kansas 2 cases of mycobacteria, abscesses, Mycobacterium turtle 8 cases, 1 case of Gordon Mycobacterium Gordon, 1 case of incidental mycobacteria. [Conclusions] It is of great significance to strengthen the monitoring of tuberculosis among the major population of entry-exit people. At the same time, the laboratory needs to increase the detection rate of sputum smear, attach importance to the technique of culturing the fluid and strive to improve the detection ability.