西藏地区169例复治失败肺结核病例耐药状况检测  

Analysis on drug resistance of 169 cases of pulmonary tuberculosis failing to respond to re-treat-ment in Tibet of China

作　　者：石荔[1] 朗珍 魏淑贞 万康林[3] 

机构地区：[1]四川大学华西临床医学院,四川成都610041 [2]西藏疾病控制中心结核病防治所 [3]中国疾病预防控制中心传染病预防控制所

出　　处：《疾病监测》2007年第6期388-389,共2页Disease Surveillance

摘　　要：目的了解西藏地区复治肺结核患者中的结核分枝杆菌对抗结核化学药物的耐药状况,为有效防治肺结核病提供科学依据。方法收集西藏自治区结核病防治所2000-2005年复治失败病例169例痰标本,用改良罗氏培养基分离培养结核分枝杆菌,绝对浓度法检测分离菌株对4种抗结核药物[链霉素(SM)、异烟肼(INH)、乙氨丁醇(ENB)、利福平(RFP)]的耐药性测定。结果共检测169株结核分枝杆菌,其中耐药株165株,总耐药率高达97.63%,其中耐多药(所耐药物中含R和H)133例,耐多药率为78.70%。复治失败的耐药率和耐多药率明显高于全国46.50%的水平。对RFP、INH、SM和EMB的耐药率分别为91.12%(154/169)、84.02%(142/169)、75.15%(127/169)和21.30%(36/169)。结论西藏地区属高耐药区,应加强结核分枝杆菌的耐药监测和控制。Objective The present study was designed to gain insight into the status of drug-resistance of Mycobacterium tuberculosis （MTB）in patients with tuberculosis （TB） in re-treatment in Tibet for providing a scientific basis for effective prevention and control of the disease. Methods Sputum samples of patients with TB who were treated in Tibet Institute of Tuberculosis Control and failed to respond to re-treatment were collected from Jan. 2000 to Dec. 2005 and MTB were cultured with Lwenstein-Jensen culture medium and isolated. The absolute concentration method was used to test drug resistance of the isolated strains to the four anti-tuberculosis drugs, streptomycin （SM）, isoniazid （INH）, ethambutol （EMB） and Rifampin （RFP）. Results A total of 169 strains of Mycobacterium tuberculosis were isolated and tested and 165 of them were found to be resistant to the drugs, with the total rate of drug resistance as high as 97.63%. It was identified that 78.70% of the drug resistant strains （133/165） were multi-drug resistant. The drug resistance rate including the rate of multi-drug resistance among those who failed to respond in re-treatment was higher than the mean value of the whole country （46.50%）. The rates of resistance to RFP, INH, SM and EMB were 91.12%（154/169）, 84.02% （142/169）,75.15% （127/169）and 21.30% （36/169）, respectively. Conclusion The surveillance and control of drug resistance of Mycobacterium tuberculosis should be strengthened in Tibet, which is identified to be an area of high drug resistance.

关 键 词：结核病 结核分支杆菌 耐药性 

分 类 号：R521[医药卫生—内科学]