1034例利福平耐药结核杆菌对其它一线抗结核药物耐药性分布特征  

Distribution characteristics of resistance to other first line anti-tuberculosis drugs among 1034 rifampin-resistant mycobacterium tuBERCULosis strains

作　　者：谢贝[1] 苏雯婕[1] 刘志辉[1] 张言斌[1] 

机构地区：[1]广州市胸科医院肺部疾病研究所,510095

出　　处：《国际医药卫生导报》2011年第13期1537-1539,共3页International Medicine and Health Guidance News

基　　金：国家“十一五”重大传染病专项资助项目（2008ZX10003-007）;广州市医药卫生科技重点项目（2009-Zdi-22）;广州市医药卫生科技重大项目（2009-ZDa-03）

摘　　要：目的了解广州市近17年来，结核分枝杆菌临床分离株利福平耐药情况及对其它一线抗结核药物的敏感性分布特征。方法回顾性分析广州市胸科医院1992年2月-2008年7月期间门诊结核病人一线抗结核药物敏感性试验结果。结果10167例结核分支杆菌分离株中，耐R菌株1034例，耐H菌株2214例，耐S菌株1073例，耐E菌株622例，总体耐药率为25．80％；在1034例R耐药株中，H、R共同耐药者927例，占R耐药株总数的89．65％，却只占2214例H耐药株的41．87％；而R、S共同耐药者502例，R、E共同耐药者237例，分别占耐R株总数的48．55％及22．92％，明显少于R、H共同耐药者。结论耐RFP菌株绝大部分同时对INH耐药，但反之不然，现有的耐药机制难以解释此种现象，结核杆菌是否存在其它耐药机制有待进一步研究。Objective To explore rifampicin-resistant status of mycobacterium tuberculosis isolates in Guangzhou during the recent seventeen years, and their distribution characteristics of susceptibility to other first line anti-tuberculosis drugs. Methods The results of first line anti-tuberculosis drug susceptibility testing performed during the period of February 1992 to July 2008 in clinic patients were retrospectively analyzed. Results Of 10 167 mycobacterium tuberculosis isolates, 1034 were rifampin-resistant, 2214 isoniazid-resistant, 1073 streptomycinresistant, and 622 ethambutol-resistant; with a total drug resistance rate of 25.80%. Of 1034 rifampin-resistant isolates, 927 also developed isoniazid resistance, being 89.65% for the total number of rifampin-resistant isolates but only 41.87% for 2214 isoniazid-resistant isolates. Meanwhile, the number of rifampin- and streptomycin -resistant （ 502 strains ） and rifampin- and ethambutol-resistant （ 237 strains ） isolates was signifieantly smaller than that of rifampin- and isoniazid-resistant isolats. Conclusions Most of rifampin-resistant isolates also develop resistance to isoniazid, but not vice versa. The existing mechanisms of drug resistance are difficult to completely explain this phenomenon. Wether mveobaeterium tuberculosis has other mechanisms of drug resistance requires further research.

关 键 词：结核杆菌 利福平 异烟肼 耐药性 分布特征 

分 类 号：R446.5[医药卫生—诊断学]