2010-2012年浙江省常山县涂阳肺结核耐药监测结果分析  

Smear-positive tuberculosis drug resistance monitoring result in Changshan, 2010-2012

作　　者：杨春英[1] 王谦信[1] 

机构地区：[1]浙江省常山县人民医院,浙江常山324200

出　　处：《现代预防医学》2015年第15期2823-2825,2845,共4页Modern Preventive Medicine

摘　　要：目的分析2010-2012年常山县涂阳肺结核患者结核分枝杆菌的耐药情况与耐药谱。方法对2010年1月-2012年12月在常山县人民医院(浙江省结核病定点医院)结核门诊诊断、治疗的涂阳肺结核病例的痰进行结核分枝杆菌培养,菌型鉴定为结核分枝杆菌的菌株采用比例法进行6种抗结核药物[异烟肼(H)、利福平(R)、乙胺丁醇(E)、链霉素(s)、左氧氟沙星(O)、卡那霉素(KM)]耐药性测试。结果 260株结核分枝杆菌病例中,总耐药率17.31%,初始耐药率和获得性耐药率分别为11.16%和55.56%,两者差异具有统计学意义(χ2=45.75,P<0.01);耐药类型,单耐药率为8.85%,多耐药率为3.08%,耐多药率为4.62%,广泛耐药率为0.77%。耐药率最高为H11.15%,S 9.23%;初治涂阳单耐药率顺位前2位是H(6.70%)和S(6.25%),而复治涂阳单耐药率顺位前2位是H(38.89%)和(36.11%);多耐药谱,初治涂阳以H+S常见,复治涂阳以R+O,H+S+O常见;耐多药谱以H+R,H+R+S常见。结论常山县总耐药率、耐多药率、初始耐药率分别低于全国第五次结核病流调的结果,获得性耐药率和耐多药率则高于全国第五次结核病流调的结果。Objective To analyze mycobacterium tuberculosis drug resistance situation and drug-resistant spectrum of patients with smear-positive pulmonary tuberculosis in Changshan from 2010 to 2012. Methods From January 2010 to December 2012, a tuberculosis（TB） fixed-point hospital in Zhejiang province Changshan county people＇s hospital, clinic diagnosis and treatment of smear-positive pulmonary tuberculosis cases sputum mycobacterium tuberculosis culture, bacteria which were identified as mycobacterium tuberculosis strain ratio method was used for 6 kinds of anti-tb drugs [isoniazid（H）, rifampicin（R）, ethambutol（E）,streptomycin（s）, levofloxacin（O）, kanamycin（KM） ] drug resistance test. Results Among 260 strains of mycobacterium tuberculosis cases, 17.31% of thewere total resistance, and the initial resistance and acquired resistance were 11.16% and 55.56%, respectively.The difference is statistically significant（χ2=45.75, P0.01）; Resistant type, monoresistance rate of was 8.85%, poly Poly- resistance rate of was 3.08%, and multi-drug resistance rate was 4.62%. Extensively drug-resistant rate of was 0.77%. H is was the highest percentages of 11.15% and S was 9.23%; Initial smear-positive monoresistance sequence of the percentages of the former two were H（6.70%） and S（6.25%）, and recurrent smear-positive monoresistance sequence of the percentages of the former two were H（38.89%） and（36.11%）. Among the Multiple drug-resistant spectrum, initial smear-positive to H ＋ S common, recurrent case with R ＋ O, H ＋ S ＋ O common; Multi-drug resistant spectrum with H ＋ R, H ＋ R ＋ S common. Conclusion The total resistance rate,multi-drug resistance rate and initial resistance rate of Changshan were lower than the results of the fifth national tuberculosis epidemiological survey, while the acquired resistance rate and the multi-drug resistance rate were higher than the results of the fifth national tuberculosis epidemiological survey.

关 键 词：肺结核 结核分支杆菌 耐药性 耐多药 监测 

分 类 号：R186[医药卫生—流行病学]