涂阳肺结核耐氟喹诺酮类药物原因分析  

Fluoroquinolones Drug Resistance With Smear Positive Pulmonary Tuberculosis

作　　者：李廷东[1] 黄永茂[2] 党员喜 肖迎军[1] 

机构地区：[1]宜宾市翠屏区疾病预防控制中心,四川宜宾644000 [2]泸州医学院附属医院感染科

出　　处：《职业卫生与病伤》2011年第4期202-204,共3页Occupational Health and Damage

摘　　要：目的分析宜宾市翠屏区涂阳肺结核患者氟喹诺酮类药物(FQS)耐药原因相关的影响因素。方法统计分析宜宾市翠屏区疾病预防控制中心2005-2010年间进行痰培养+药敏试验检查的76例涂阳肺结核患者痰培养菌株FQS的耐药检查结果,结合患者临床病史调查分析肺结核患者FQS耐药相关的影响因素。结果76例涂阳肺结核患者的FQS耐药率为30.3%,估算宜宾市翠屏区涂阳肺结核FQS耐药率为20.3%～40.3%(95%CI)。复治涂阳患者FQS耐药率比初治涂阳患者耐药率高,初治涂阳、复治涂阳肺结核患者使用FQS的主要原因分别是诊断性抗感染治疗和抗结核治疗。复治、FQS用药史是产生FQS耐药性的危险因素,督导服药是减少耐药的保护性因素。结论不规范使用FQS和自服药抗结核治疗方式是宜宾市翠屏区肺结核患者发生FQS耐药的主要原因,应加强DOTS治疗策略的落实和加大对耐药结核病控制的政府投入。Objective To analyze the influential factors relevant to the reasons of Fluoroquinolones drug resistance.Methods During 2005 to 2010,Cuiping district center for disease control and prevention of Yibin had collected Mycobacterium tuberculosis culture and drug susceptibility test results for 76 positive patients＇ sputum samples and their clinical history to analyze influential factors of Fluoroquinolones drug resistant.Results Among the 76 positive patients,30.3% were FQS drug resistant.Based on that,the estimated rate for smear positive tuberculosis was 20.3%-40.3%（95%CI） in Cuiping district of Yibin.Drug resistance rate of re-treatment smear positive tuberculosis patients was higher than that of untreated smear positive tuberculosis patients.The main reasons for untreated smear positive tuberculosis and re-treatment patients to use FQS was fighting infection for diagnosis and anti-tuberculosis treatment respectively.Re-treatment,FQS medication history are the risk factors causing drug resistance,while the protective factor for reducing drug resistance was guided medication.Conclusions Non-standard usage of FQS and self-medication to treat tuberculosis are the main reasons which lead to FQS resistance in tuberculosis patients in Cuiping district of Yibin.

关 键 词：肺结核 氟喹诺酮类 耐药 影响因素 

分 类 号：R521[医药卫生—内科学]