许昌市363株结核分枝杆菌耐药性和菌型分析  

Analysis of drug resistance and strain type of 363 Mycobacterium tuberculosis in Xuchang

作　　者：宁红晓 NING Hong-xiao(Anti-tuberculosis Institute of Xuchang,Xuchang,Henan 461000,China)

机构地区：[1]河南省许昌市结核病防治所,河南许昌461000

出　　处：《现代预防医学》2020年第14期2631-2633,2643,共4页Modern Preventive Medicine

摘　　要：目的分析河南省许昌市363株结核分枝杆菌对9种抗结核药物的耐药和菌型分析,为结核病防治工作提供参考依据。方法收集2016-2017年许昌市结防机构分离培养的363株结核分枝杆菌分离株,采用比例法进行9种抗结核药物(INH、RFP、SM、EMB、OFX、KM、CPM、PTO、PAS)敏感试验和菌群鉴定试验。耐药率的比较采用χ2检验。结果363株结核分枝杆菌总耐药率、单耐药率和耐多药率分别为24.24%(88/363),11.85%(42/363),7.44%(27/363);获得性耐药率明显高于初始耐药率,两者差异有统计学意义(χ2=38.496,P<0.001);9种药物耐药顺位为SM 14.33%(52/363)>INH 12.12%(44/363)>RFP 10.47%(38/363)>OFX 4.96%(18/363)>EMB 3.03%(11/363)>CPM 1.93%(7/363)>PAS0.83%(3/363)>KM 0.55%(2/363)>PTO 0.28%(1/363);共出现了11种耐多药谱类型;结核病分枝杆菌以人结核分枝杆菌为主,人结核分枝杆菌耐药率(30.71%,82/267)高于牛结核分枝杆菌(6.25%,6/96),两者差异有统计学意义(χ2=23.007,P<0.001)。结论许昌市结核病总耐药率低于全国耐药水平,而耐多药率高于全国水平。复治患者耐药率仍然比较高,因此耐药结核病防治工作成为今后许昌市结核病防治工作的重点。Objective To analyze drug resistance to 9 kinds of anti-TB drugs of Mycobacterium tuberculosis and strain type in Xuchang, and to provide scientific reference for treatment of tuberculosis. Methods A total of 363 Mycobacterium tuberculosis isolated were collected from 2016 to 2017, and identified their strain type and drug resistance to 9 kinds of antiTB drugs(INH、RFP、SM、EMB、OFX、KM、CPM、PTO、PAS) by drug sensitivity test(DST). The Chi-square test was used for categorical date comparison. Results The total-resistant rate, mono-resistant rate and multidrug-resistant rate of the 363 Mycobacterium tuberculosis were 24.24%(88/363), 11.85%(42/363) and 7.44%(27/363). There was significant difference(χ2=38.496, P<0.001) between the initial patients and the acquired patients. The order of drug resistance was SM(14.33%) >INH(12.12%) > RFP(10.47%) > OFX(4.96%) >EM(B3.03%) > CPM(1.93%) > PAS(0.83%) > KM(0.55%) >PTO(0.28%).There were 9 kinds of drug resistance. The drug resistant rates of human Mycobacterium tuberculosis(30.71%) was higher than bovine Mycobacterium tuberculosis(6.25%), and there was significant difference(χ2=23.007, P<0.001). Conclusion The totalresistant rate was lower than the national drug resistant level, but the multidrug-resistant rate was higher than the national drug resistant level. The drug resistance rate in retreatment patients remained high. The work of drug-resistant TB should be the focus of Xuchang’s tuberculosis prevention and control work in the future.

关 键 词：结核 分枝杆菌 耐药 

分 类 号：R115[医药卫生—公共卫生与预防医学]