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The purpose of (1) the results of the bacteriological analysis the tuberculosis specimens of surgical resection and bone and joint TB specimens, evaluation of drug treatment efficacy monitoring tools to explore the significance of surgical specimens bacteriological examination of preoperative assessment of the efficacy of anti-TB treatment and surgical treatment of tuberculosis guidance value of postoperative chemotherapy. (2) study drug-resistant clinical isolates of INH, RFP and SM dependency situation, explore the chemotherapy drug dependent relationship MTB guide clinical rational anti-TB treatment. Method (1) of 38 cases of tuberculosis surgical specimens and 19 cases of bone and joint tuberculosis specimens MTB liquid culture and the the Roche culture and strain identification and drug susceptibility testing, patients with tuberculosis sputum MTB and patients with bone and joint tuberculosis pus MTB results for comparison. (2) Select the five cases the Roche culture and selective 7H9 liquid culture were negative for TB specimens of tissue suspension (experimental group), Roche, one cases of culture-positive and vigorous growth of MTB H37RV were inoculated three guinea pigs (positive control group ), and unvaccinated MTB of two guinea pigs (negative control group) after 4 weeks were sacrificed by air embolism guinea pigs, sterile anatomy, the lungs were observed and tissue homogenates culture, culture negative tuberculosis lesions to understand MTB of MTB metabolic state. (3), 65 drug-resistant clinical isolates were inoculated from Lowenstein-Jensen medium containing different concentrations of INH, RFP and SM culture, different experimental medium (control medium, the drug-containing medium) in the colony counts and morphology; analyze the resistance of each strain and drug dependence. Results (1) lung surgical specimens MTB culture positive rate was 63.2% (24/38), sputum MTB culture positive rate was 18.4% (7/38), the difference was statistically significant (Fisher's exact, P = 0.033 , P lt; 0.05). Specimens of bone and joint surgery MTB culture positive rate was 42.1% (8/19), The pus MTB culture positive rate was 21.1% (4/19), the difference was statistically significant (Fisher's exact test, P = 0.018, P lt ; 0.05). MTB susceptibility results of sputum MTB susceptibility results in surgical specimens of patients with pulmonary tuberculosis coincidence rate was 83.9%, Kappa value was 0.667, P gt; 0.05, the difference was not statistically significant; surgical specimens of patients with bone and joint tuberculosis MTB MTB susceptibility results of susceptibility results with pus in line with rate of 91.7%, Kappa = 0.807, P gt; 0.05, the difference was not statistically significant. Drug sensitivity test 24 culture-positive pulmonary MTB strains have different levels of resistance; sick time is shorter than 120 months (0-120 months), chemotherapy regimens shorter than 24 months (0-24 months) The basic lesions empty of patients, MTB culture-positive rate; imaging has stabilized fibrosis, calcifications, MTB culture positive rate is still higher. 8 MTB culture-positive bone and joint tuberculosis strains in drug-sensitive experiments, five drug-resistant strains. (2) four weeks after infection, anatomy visible: the experimental group first 4,5,8,11 guinea pig lung congestion, swelling, surface protruding nodules; No. 3 guinea pig lung dark red, smooth surface, no protruding nodules. Tissue culture, bacterial growth was observed: the experimental group No. 4,5,8,11, culture-positive and culture-negative; No. 3. Consistent with the results observed with the naked eye. (3) 21 resistant clinical isolates of drug-containing medium colony growth is more vigorous than in the control medium; INH, RFP and SM dependent rate of 1.5%, 20% and 18.5%, and dependent existence A , B, C, D are four types; Most of the cases the presence of drug dependence, over a long period of irrational, irregular anti-TB treatment. Conclusion (1) sputum bacteriology results can not be used as the only means of tuberculosis treatment efficacy monitoring should be read in conjunction with the duration of disease, treatment and lesion imaging performance analysis, judgment. The preoperative chemotherapy need reasonable rules lesions MTB to minimize the amount of bacteria. The surgical treatment of tuberculosis is the complete removal of the lesion, and an effective means to avoid relapse and become resistant TB. Sputum or pus specimens bacteriology results can not be fully representative of the bacteria in the lesions, lesions surgery for culture and sensitivity test, and a larger role in guiding the clinical treatment of postoperative. (2) liquid and Roche culture negative specimens, not necessarily within the lesion without MTB, but by the impact of the detection limit; Withholding bacteria may exist. (3) resistant clinical isolates of INH, RFP and SM shows dependence, and dependence characteristics; tuberculosis patients with long-term unreasonable, irregular medication, may be the main reason for the dependent phenomenon.
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