2017年浙江省宁波市肺结核患者耐药特征分析  

Drug resistance of pulmonary tuberculosis cases in Ningbo, Zhejiang, 2017

作　　者：陈同[1] 杨天池[1] 林相[1] 王思嘉 平国华[1] 车洋[1] 林律[1] 于梅[1] Chen Tong;Yang Tianchi;Lin Xiang;Wang Sijia;Ping Guohua;Che Yang;Lin Lyu;Yu Mei(Institute for Tuberculosis Prevention and Control,Ningbo Prefecture Center for Disease Control and Prevention,Ningbo 315010,Zhejiang,China)

机构地区：[1]宁波市疾病预防控制中心结核病防制所

出　　处：《疾病监测》2019年第10期924-927,共4页Disease Surveillance

基　　金：宁波市自然科学基金(No.2018A610405);浙江省医药卫生科技项目(No.2018KY733)~~

摘　　要：目的初步了解浙江省宁波市初治涂阴肺结核患者耐药情况,为完善耐药肺结核控制策略提供参考信息。方法对2017年3-12月宁波市各级结核病定点医院登记的1434例初治涂阴肺结核患者的痰标本进行分离培养,采用世界卫生组织/国际防痨和肺病联合会推荐的比例法对培养阳性菌株开展菌种鉴定和药物敏感性检测。结果1434例初治涂阴肺结核患者中378例培养阳性,其中60例鉴定为非结核分枝杆菌感染,318例结核分枝杆菌感染者中86例为耐药患者,总耐药率为27.04%,异烟肼耐药率最高,为17.92%(57/86);利福平耐药率最低,为5.35%(17/86)。有空洞肺结核患者利福平耐药率高于无空洞患者(χ~2=5.319,P<0.05)。结论宁波市初治涂阴肺结核疫情较为严峻,需进一步扩大筛查范围,及时发现和诊断耐药肺结核患者,提高患者治疗和管理水平。Objective To evaluate the levels and patterns of drug resistance in initially treated smear-negative pulmonary tuberculosis(TB)patients in Ningbo,and provide scientific evidence for the prevention and control of drug-resistant TB.Methods Sputum samples of 1434 initially treated smear-negative pulmonary TB patients enrolled from March to December2017 were isolated by liquid culture method.Strain identification and drug susceptibility tests were performed for all culture positive samples with proportion method.Results A total of 378 sputum samples from the 1434 enrolled pulmonary TB patients were culture positive,in which 60 were non-tuberculosis mycobacterium positive.Eight six of 318 pulmonary TB cases were drug-resistant,the overall drug-resistance rate was 27.04%,with the highest resistance rate to isoniazid(17.92%,57/86),and the lowest drug-resistance rate to rifampicin(5.35%,17/86).The resistance rate to rifampicin in pulmonary TB patients with cavitation was significantly higher than that in those without cavitation(χ~2=5.319,P<0.05).Conclusion The drug resistance in initially treated smear-negative pulmonary TB cases was relatively severe in Ningbo.Further efforts should be made to expand drug susceptibility test coverage to find drug-resistant patients timely and improve the treatment and management of pulmonary TB cases.

关 键 词：结核 肺 分枝杆菌 药物敏感性 耐药 

分 类 号：R521[医药卫生—内科学]