秦皇岛市320株结核分枝杆菌的耐药性分析  

Analysis of drug resistance of 320 strains of Mycobacterium tuberculosis in Qinhuangdao

作　　者：王宝英[1] 孙强[2] 李艳静[3] 张健[1] 刘鹏[1] 张继东[1] 闫佳会 张蕊 WANG Bao-ying;SUN Qiang;LI Yan-jing;ZHANG Jian;LIU Peng;ZHANG Ji-dong;YAN Jia-hui;ZHANG Rui(Department of Laboratory,the Third Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China;Department of Internal Medicine-Cardiovascular,the First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China;Department of Pulmonary,the Third Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛市第三医院检验科,河北秦皇岛066000 [2]秦皇岛市第一医院心内科,河北秦皇岛066000 [3]秦皇岛市第三医院肺二科,河北秦皇岛066000

出　　处：《临床肺科杂志》2019年第11期2004-2008,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的通过对秦皇岛市分离的320株结核分枝杆菌进行培养与耐药性分析,为临床合理用药及结核病的早期防治提供参考。方法收集痰结核菌培养阳性标本376份,采用比例法进行药物敏感试验,分析本地区结核病的耐药现状与人口学特征的关系;结果376株分枝杆菌经鉴定,结核分枝杆菌复合群占85.1%(320/376),非结核分枝杆菌占14.9%(56/376)。320株结核分枝杆菌总耐药率为37.2%(119/320);四种一线药物耐药率由高到低依次是链霉素为19.7%(63/320),异烟肼为17.5%(56/320),利福平为11.3%(36/320),乙胺丁醇为9.7%(31/320);单耐药结核病占13.4%(43/320),多耐药结核病占7.2%(23/320),耐多药结核病所占比例为9.1%(29/320);青年组中,复治患者对INH和RFP的耐药率高于初治患者(P<0.05);中年组中,复治患者对EMB的耐药率高于初治患者(P<0.05);老年组中,复治患者对RFP的耐药率高于初治患者(P<0.05);复治患者MDR-TB发生率明显高于初治患者。结论我院耐药结核病比率低于全国水平,仍需加强对结核病规范治疗和耐药监测。Objective To provide reference for clinical rational drug use and early prevention and treatment of tuberculosis through the culture and drug resistance analysis of 320 strains of Mycobacterium tuberculosis isolated in Qinhuangdao.Methods 376 samples of positive tuberculosis cultures from hospitalized and outpatients were collected and cultured.Drug sensitivity was tested by using the proportional method.The relationship between drug resistance status and demographic characteristics of tuberculosis in this region was analyzed.Results A total of 376 TB cases were enrolled.56 samples(14.9%)were non-tuberculosis mycobacteria(NTM)infection and 320 samples(85.1%)were Mycobacterium tuberculosis complex.The results showed that drug resistance rate of 320 mycobacterium tuberculosis was 37.2%.The highest resistance rate of the four first-line drugs were 19.7%for streptomycin,17.5%for isoniazid,11.3%for rifampicin,9.7%for ethambutol,and single-drug resistant tuberculosis accounted for 13.4%,multi-drug resistant tuberculosis accounted for 7.2%,and multidrug-resistant tuberculosis accounted for 9.1%.In the youth group,the resistance rate of the retreated patients to INH and RFP was higher than that of the newly treated patients(P<0.05).In the middle-aged group,the resistance rate of the retreated patients to EMB was higher than that of the newly treated patients(P<0.05).In the elderly group,the resistance rate of the retreated patients to RFP was higher than that of the newly treated patients(P<0.05).The MDR-TB rate of the recurrent treatment group was significantly higher than the initial treatment group,and the difference was statistically significant.Conclusion Drug-resistant tuberculosis rate in our hospital is lower than the national level.It is still necessary to strengthen the standardized treatment of tuberculosis and drug resistance monitoring.

关 键 词：结核分枝杆菌 耐药性 结核病 

分 类 号：R52[医药卫生—内科学]