铜陵市2017～2018年初治与复治结核病患者耐药情况分析  

Analysis of drug resistance of TB patients treated and retreated in Tongling city from 2017 to 2018

作　　者：左延才 龙凤娟 ZUO Yancai;LONG Fengjuan(Tuberculosis Reference Laboratory,Center for Disease Control and Prevention,Tongling City,Tongling 244000,China)

机构地区：[1]安徽省铜陵市疾控中心结核病参比实验室

出　　处：《安徽医学》2019年第12期1339-1342,共4页Anhui Medical Journal

基　　金：安徽省结核病耐药性基线调查实施性研究(项目编号:15TB010)

摘　　要：目的分析铜陵市初治与复治结核病耐药现状和特点,掌握结核分支杆菌的耐药谱,为铜陵市结核病疫情制定防控策略提供依据。方法选取2017~2018年铜陵市耐药监测点的888例初治与复治结核病患者的痰标本进行萋尼氏抗酸染色、结核分支杆菌培养、药物敏感性试验以及菌群鉴定。采用比例法对结核分支杆菌复合群进行药物敏感性试验,并进行统计学分析。结果在888例初治与复治结核病患者样本中,319例为结核分支杆菌复合群,其中初治结核病患者262例,复治结核病患者57例。总耐药率为19.75%(63/319),初治结核病患者耐药率为15.65%(41/262),复治结核病患者耐药率为38.60%(22/57)。总耐多药率为10.66%(34/319),初治结核病患者耐多药率为6.11%(16/262),复治结核病患者耐多药率为31.58%(18/57)。8种抗结核药耐药率顺位依次为异烟肼(10.34%)、链霉素(7.52%)、利福平(6.90%)、卷曲霉素(6.90%)、对氨基水杨酸钠(4.70%)、氧氟沙星(3.76%)、卡那霉素(2.82%)、乙胺丁醇(2.19%)。结论铜陵市初治和复治结核病耐药疫情依然严重,仍需要采取更加有效、全面、及时的干预管理办法,减少结核病耐药性产生。Objective To analyze the current situation and characteristics of TB drug resistance in the primary treatment and the secondary treatment of Tongling city,to master the drug resistance spectrum of mycobacterium tuberculosis,and to provide the basis for formulating prevention and control strategies of TB epidemic in Tongling city.Methods From 2017 to 2018,sputum specimens of 888 cases of tuberculosis patients with primary treatment and retreatment were selected from Tongling drug resistance monitoring points for zellni acid-resistant staining,mycobacterium tuberculosis culture,drug sensitivity test and bacterial community identification.The drug sensitivity test of mycobacterium tuberculosis compound group was carried out by proportional method,and statistical analysis was made.Results Among the 888 cases of TB patients,319 cases were mycobacterium tuberculosis compound group,including 262 cases of TB patients and 57 cases of TB patients.The total drug resistance rate was 19.75%(63/319),the drug resistance rate was 15.65%(41/262)and 38.60%(22/57).The total mdr-tb rate was 10.66%(34/319),the mdr-tb rate was 6.11%(16/262)in the first treatment,and the mdr-tb rate was 31.58%(18/57)in the second treatment.The drug resistance rates of 8 anti-tuberculosis drugs were isoniazid(10.34%),streptomycin(7.52%),rifampicin(6.90%),capreomycin(6.90%),p-aminosalicylate(4.70%),ofloxacin(3.76%),kanamycin(2.82%)and ethambutol(2.19%).Conclu sions The epidemic situation of TB drug resistance in Tongling is still serious,and more effective,comprehensive and timely intervention management measures should be taken to reduce the occurrence of TB drug resistance.

关 键 词：初治结核病 复治结核病 结核分支杆菌 耐药率 

分 类 号：R446.5[医药卫生—诊断学] R52[医药卫生—临床医学]