云南省846株结核分枝杆菌药敏试验结果  

Analysis of 846 Strains of Mycobacterium Tuberculosis to Anti-tuberculosis Drug in Yunnan Province

作　　者：陈连勇[1] 茹浩浩 杨星[1] 闫双群[1] 陈金瓯[1] 杨蕊[1] 陈涛 许琳[1] CHEN Lian-yong;RU Hao-hao;YANG Xing;YAN Shuang-qun;CHEN Jin-ou;YANG Rui;CHEN Tao;XU Lin(Dispensary for Tuberculosis Control and Prevention,Yunnan Center for Disease Control and Prevention,Kunming Yunnan 650022,China)

机构地区：[1]云南省疾病预防控制中心结核病防治所,云南昆明650022

出　　处：《昆明医科大学学报》2020年第3期45-49,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81560544)。

摘　　要：目的了解目前云南省结核患者的耐药情况,为耐药结核病的防控提供可供参考的科学依据。方法收集2016年1~12月云南省32耐药监测县(区)分离的分枝杆菌菌株,采用比例法开展其对利福平(RFP)、异烟肼(INH)、链霉素(SM)乙胺丁醇(EMB)、氧氟沙星(OFX)和卡那霉素(KM)6种抗结核药物的敏感性试验。结果共获得846株结核分枝杆菌,总耐药率为20.69%(175/846),耐多药(MDR)率为3.78%(32/846),其中初治MDR率为2.94%(22/749),复治MDR率为10.31%(10/97),复治MDR率显著高于初治MDR率(χ^2=12.82,P<0.01);59.26%(32/54)的利福平耐药株同时对异烟肼耐药,多元回归分析显示,复治患者是MDR肺结核发生的危险因素。结论云南省近年来耐药率有所下降,复治是MDR的高危因素,但原发性耐药不容忽视,应尽早发现耐药结核并进行规范化治疗管理,避免耐药结核病的传播。Objective To understand the prevalence of drug-resistant tuberculosis in Yunnan province,so as to provide scientific basis for efficient control of drug-resistant tuberculosis.Methods Mycobacterium tuberculosis(MTB)strains were collected from 32 counties of drug-resistant monitoring sites from January to December 2016,and proportion methods were employed for drug susceptibility test(DST),including:rifampicin(RFP),isoniazid(INH),streptomycin(SM),ethambutol(EMB),ofloxacin(OFX)and kanamycin(KM).Results The overall drug resistance rate of 846 MTB strains to 6 anti-tuberculosis drugs was20.69%(175/846),and the multidrug-resistant(MDR)rate was 3.78%(32/846),2.94%(22/749)for new TB patients and10.31%(10/97)for re-treated TB patients.The multi-drug resistance rate of re-treated TB patients was significantly higher than that of newTB patients(χ^2=12.82,P<0.01).There were 54 rifampicin-resistant strains,32(59.26%)of which were isoniazid-resistant.Results of multivariate logistic regression analysis showed that retreatment was a risk factor for MDR.Conclusions The drug resistance rate of tuberculosis in Yunnan is lower than before and retreatment is a high risk factor of MDR,but drug resistance of new TB patient is not optimistic.Drug-resistant TB patients should be detected as early as possible and standardized treatment and management should be carried out to avoid the spread of drug-resistant tuberculosis.

关 键 词：结核病 结核分枝杆菌 耐药 耐多药 

分 类 号：R521[医药卫生—内科学]