2013—2016年西安市未央区结核病耐药性监测  

Drug resistance surveillance of tuberculosis in Weiyang District of Xi'an City from 2013-2016

作　　者：王二谋 秦国富[2] 柳巍[2] 曾令城[2] 王艳飞[2] WANG Er-mou1,QIN Guo-fu2,LIU Wei2,ZENG Ling-cheng2,WANG Yan-fei2(1.Office, Weiyang Center for Disease Control and Prevention ,Xi＇an Shoanxi , 710016 , China ; 2.Tuberculosis Control Division,Xi＇an Center for Disease Control and Prevention,Xi＇an Shaanxi , 71005d, China)

机构地区：[1]西安市未央区疾病预防控制中心办公室,陕西西安710016 [2]西安市疾病预防控制中心结核病防治科,陕西西安710054

出　　处：《职业与健康》2018年第21期2943-2946,共4页Occupation and Health

基　　金：陕西省重点研发计划项目(2017SF-384)

摘　　要：目的了解2013—2016年西安市未央区结核分支杆菌耐药的流行状况,为下一步西安市耐药防治政策的制定提供依据。方法依照国家耐药性监测实施方案的要求,对2013—2016年西安市未央区所有新发涂阳肺结核患者进行痰培养,培养阳性菌株再进行菌种鉴定和6种抗结核药物[异烟肼(INH),利福平(RFP),乙胺丁醇(EMB),链霉素(SM),卡那霉毒(KAM),氧氟沙星(OFX)]的药物敏感性试验。结果监测新登记涂阳肺结核患者195例,其中初治173例,复治22例。总耐药率为44.62%,其中初治患者总耐药率为41.62%,复治患者总耐药率为68.18%,差异有统计学意义(χ~2=5.57,P<0.05);总耐多药率为13.33%,其中初治患者耐多药率为11.56%,复治患者耐多药率为27.27%,差异有统计学意义(χ~2=4.17,P<0.05)。对6种抗结核药物(INH,RFP,EMB,SM,KAM,OFX)的耐药率分别是25.13%、20.51%、5.64%、30.26%、5.64%和15.90%,SM和INH耐药率居前两位。结论 2013—2016年西安市未央区耐药结核病形势严峻,处于较高的水平。应加强耐药结核病的防治,政府要加大投入力度,并根据耐药情况制定出详细的防治方案。[Objective]To understand the prevalence of drug resistance of Mycobacterium tuberculosis in Weiyang District of Xi＇an City from 2013-2016,provide the basis for the formulation of Xi＇an resistance control policy. [Methods] According to the requirements of the national drug resistance monitoring implementation program,all newly-emerged smear-positive pulmonary tuberculosis patients in Weiyang District of Xi＇an City from 2013-2016 were recruited for the sputum culture. The positive strains were analyzed by the strain identification and the drug sensitivity test for six anti-tuberculosis drugs,including isoniazid（INH）,rifampicin（RFP）,ethambutol（EMB）,streptomycin（SM）,kanamycin（KAM） and ofloxacin（OFX）. [Results] A total of 195 newly registered patients with pulmonary tuberculosis were analyzed in the current surveillance,of which 173 were initially treated and22 were retreated. The total resistance rate was 44.62%,of which the total resistance rate was 41.62% in the newly diagnosed patients while 68.18% in retreatment patients,and the difference was statistically significant（χ^2=5.57,P〈0.05）. The total multidrug resistance rate was 13.33%,of which the rate was 11.56% in the newly diagnosed patients while 27.27% in retreatment patients,and the difference was statistically significant（χ^2=4.17,P〈0.05）. The resistance rate to INH,RFP,EMB,SM,KAM and OFX was respectively 25.13%,20.51%,5.64%,30.26%,5.64% and 15.90%,and SM and INH were the top two of resistance rate.[Conclusion] The situation of drug-resistant tuberculosis in Weiyang District of Xi＇an City from 2013-2016 is grim and at a high level. It is necessary to strengthen the prevention and treatment of drug-resistant tuberculosis. The government should increase investment and formulate a detailed prevention and treatment plan according to drug resistance.

关 键 词：肺结核 结核分支杆菌 监测 耐药性 

分 类 号：R446.5[医药卫生—诊断学]