2013—2014年海南省初复治涂阳肺结核患者耐药监测结果分析  

Analysis of drug resistance surveillance results of initial and retreatment snnear-positive pulmonary tuberculosis in Hainan province, 2013-2014

作　　者：黄静静[1] 熊昌富[1] 王春雷[1] 符彩云[1] 罗兴雄[1] 陈成江[1] 陈亚玲[1] HUANG Jing-jing XIONG Chang-fu WANG Chun-lei FU Cai-yun LUO Xing-xiong CHEN Cheng-jiang CHEN Ya-ling.(Department of TB Control and Prevention, Hainan Provincial Center for Disease Control and Prevention, Haikou 570203, Chin)

机构地区：[1]海南省疾病预防控制中心传染病预防控制所结核病预防控制科,海口570203

出　　处：《中国防痨杂志》2017年第1期95-99,共5页Chinese Journal of Antituberculosis

基　　金：海南省自然科学基金项目（0107547008）

摘　　要：目的分析海南省2013年11月至2014年3月各市（县）门诊登记的初、复治涂阳肺结核患者的耐药状况。方法对海南省各市（县）2013年11月至2014年3月期间发现登记的345例涂阳肺结核患者痰标本进行分离培养，培养阳性菌株送至海南省疾病预防控制中心结核病参比实验室进行菌种鉴定，并进行6种抗结核药物[利福平（RFP）、异烟肼（INH）、链霉素（Sin）、乙胺丁醇（EMB）、氧氟沙星（Ofx）、卡那霉素（Kin）]的药物敏感性试验，对各种药物的初始耐药率、获得性耐药率、耐多药率、耐药顺位，以及不同性别、不同年龄组耐药率的差异进行分析。采用SPSS19．0软件进行数据的处理和分析，以P〈O．05为差异有统计学意义。结果全省登记的345例涂阳肺结核患者中，共获得结核分枝杆菌菌株268株，总耐药率为25．75％（69／268），总耐多药率为10．07％（27／268）。初始耐药率及获得性耐药率分别为19．OO％（42／221）和57．45％（27／47），获得性耐药率高于初始耐药率，差异有统计学意义（χ2=29．51，P〈0．01）。耐单药率顺位由高到低依次为Sm（16．42％，44／268）、INH（15．30％，41／268）、RFP（11．19％，30／268）、Ofx（8．58％，23／268）、EMB（5．60％，15／268）、Km（1．49oA，4／268）。268例患者中，18岁组患者118例，耐药41例（34．75％）；40岁组患者100例，耐药35例（35．00％）；≥60岁组患者50例，耐药20例（40．00oA），各年龄组耐药率差异无统计学意义（χ2=0．51，P=0．776）。患者中男207例，耐药55例（26．57％）；女61例，耐药14例（22．95％），不同性别耐药率差异无统计学意义（χ2=0．32，P=0．570）。结论海南省结核病患者总体耐药水平较高，需继续加强对海南省结核病患者耐药性的监测。Objective To analyze the drug resistance status of new and retreatment smear positive pulmonary tuberculosis registered from Nov. 2013 to Mar. 2014 in Hainan province. Methods Phlegm specimens of 345 cases of smear positive pulmonary tuberculosis patients registered between Nov. 2013 and Mar. 2014 were cultured and culture-positive strains were sent to provincial TB reference laboratory for strains identification, and anti-tuber- culosis drug susceptibility tests of isoniazid （INH）, streptomycin （Sin）, rifampicin （RFP）, ethambutol （EMB）, ofloxacin （Ofx） and kanamycin （Km）. Rate of drug resistance, acquired drug resistance, multidrug-resistant rate, rank of drug resistance and drug-resistance of different gender, different age groups was analyzed. SPSS 19.0 software was used for data processing and analysis, and P〈0. 05 was considered statistically significant difference. Results In 345 registered cases of smear-positive pulmonary tuberculosis patients in the whole province, a total of 268 strains of Mycobacterium tuberculosis were obtained, and the total resistance rate was 25.75% （69/268）, multi- drug-resistant rate was 10.07% （27/268）. Initial drug resistance rate and acquired drug resistance rate was 19.00% （42/221） and 57.45% （27/47） respectively, and acquired drug resistance rate was higher than the initial drug resistance rate, there was a statistically significant difference （χ2= 29.51, P〈0.01）. Drug resistance rates ranked from high to low as Sm （16.42%, 44/268）, INH （15.30%, 41/268）, RFP （11.19%, 30/268）, Ofx （8.58%, 23/268）, EMB （5.60%, 15/268）, Krn （1.49%, 4/268）. In 268 patients, 118 patients in 18-age group, 41 caseswere drug resistance （34. 75%） ; 100 cases in 40-age group, 35 cases were drug resistance （35.00%） ; 50 cases in 60-age group, 20 cases were drug resistance （40. 00%）. There was no statistically significant differences in resistance rate in each age group （χ2 =0.51, P=0. 776）. There were 207 male pat

关 键 词：结核 肺 结核 抗多种药物性 人群监测 

分 类 号：R521[医药卫生—内科学]