2014-2017年乐山市203株结核分枝杆菌耐药性分析  

Drug Resistance Analysis of 203 Strains of Mycobacterium Tuberculosis From 2014 to 2017 in Leshan City

作　　者：刘昕亮[1] 曹铸[1] 牟怀德[1] 李娜[1] 吴薇[1] 张涛[1] LIU Xinliang;CAO Zhu;MOU Huaide;LI Na;WU Wei;ZHANG Tao(Leshan Center for Disease Control and Prevention,Leshan 614000,Sichuan Province,China)

机构地区：[1]乐山市疾病预防控制中心,四川乐山614000

出　　处：《预防医学情报杂志》2019年第5期458-463,共6页Journal of Preventive Medicine Information

摘　　要：目的了解2014-2017年乐山市结核病耐药情况,为乐山市结核病防控提供科学依据。方法对2014-2017年乐山市各县区结核病实验室送检的203株结核分枝杆菌进行耐药性分析,将乐山各县区送检的菌株进行传代处理后采用比例法进行检测,严格按照《结核分枝杆菌药物敏感试验标准化操作程序及质量保证手册》要求进行实验操作和结果判断。率的比较采用χ2检验。结果 203株结核分枝杆菌总耐药率、耐多药率分别为21.18%和5.42%,不同性别、年龄、职业、县区、学历和民族间耐药率均无统计学意义,结核病高耐药率以乐山市中心城区及其边远山区的分布为主要特征,人群分布主要集中在60岁以上,单个抗结核药物耐药分析中OFX耐药率最高达4.93%,两种及两种以上抗结核药物中总耐药率较高的依次为INH+SM(3.45%)、INH+RFP(2.96%)和INH+SM+RFP(1.97%),其中INH+RFP组合在不同患者中差异有统计学意义(χ2=9.414,P=0.009),复治患者中各种抗结核药物的耐药率普遍高于初治患者和涂阴患者。结论乐山地区结核病总体耐药率和耐多药率低于全国耐药水平,但在老年人群、中心城区及边远山区耐药率仍相对较高,同时复治患者中耐药率仍居高不下,已经成为乐山市今后结核病防控工作的重点。Objective To understand the drug resistance of tuberculosis in Leshan city from 2013 to2017,providing the scientific basis for the tuberculosis prevention and control in Leshan. Methods The drug resistance analysis was conducted in 203 strains of mycobacterium tuberculosis sent by the tuberculosis labs of counties and districts in Leshan from 2014 to 2017. Bacterial strains sent by the counties and districts of Leshan were passaged and then detected by proportion method. The experimental operation and result judgment were conducted in strict accordance with the requirements in Standardization Operation Procedure and Quality Guarantee Manual of Drug Sensitivity Test for Mycobacterium Tuberculosis. Chi-square test was used for rate comparison.Results The total drug resistance rate and multi-drug resistance rate of the 203 strains of mycobacterium tuberculosis were 21.18% and5.42% respectively. There was no statistical difference in drug resistance rate between different genders, ages, occupations, counties,districts, educational levels and nationalities. High drug resistance rate of tuberculosis was featured with the distribution in the central urban area and remote mountain area of Leshan and concentrated on people older than 60 years old. The single anti-tuberculosis drug resistance analysis showed that OFX had the highest drug resistance rate(4.93%). Total drug resistance rate of two antituberculosis drugs or above included INH+SM(3.45%),INH+RFP(2.96%) and INH+SM+RFP(1.97%). INH + RFP had statistical difference in different patients(χ^2=9.414,P=0.009). Drug resistance rate of various anti-tuberculosis drugs in retreatment patients was higher than the untreated patients and patients with smear-negative. Conclusion Total drug resistance rate and multi-drug resistance of tuberculosis in Leshan were lower than the national drug resistance level,but the drug resistance rate in the elderly, central urban area and remote mountain area was still high,meanwhile,drug resistance rate in retreatment patients remained high,

关 键 词：结核病 药敏试验 耐药结核 耐多药结核 

分 类 号：R521[医药卫生—内科学] R446.5[医药卫生—临床医学]