北京市结防机构结核病患者耐药情况对比分析  

Comparative analysis on drug resistance of tuberculosis patients in Beijing's prevention and control institutions

作　　者：易俊莉[1] 杨新宇[1] 陈昊 赵琰枫 陈双双 张洁[1] 丁北川[1] 武文清[1] YI Jun-li;YANG Xin-yu;CHEN Hao;ZHAO Yan-feng;CHEN Shuang-shuang;ZHANG Jie;DING Bei-chuan;WU Wen-qing(Beijing Research Institute for Tuberculosis Control,Beijing 100035,China)

机构地区：[1]北京结核病控制研究所中心实验室,北京100035

出　　处：《临床肺科杂志》2021年第8期1135-1138,共4页Journal of Clinical Pulmonary Medicine

基　　金：首都卫生发展科研专项(No.2018-1-1041)。

摘　　要：目的分析2009年2019年北京市结防机构结核病患者临床分离株耐药情况变化。方法对2009年2019年北京市结防机构分枝杆菌培养阳性临床分离株进行初步菌种鉴定及药物敏感性试验。结果2009年1554株分枝杆菌阳性分离株中,结核分枝杆菌(MTB)1506株(96.9%),非结核分枝杆菌(NTM)48株(3.1%)。2019年1241株分枝杆菌阳性分离株中,MTB1156株(93.2%),NTM85株(6.8%)。2019年NTM分离率明显高于2009年,差异有统计学意义(χ^(2)=21.530,P<0.001)。2019年MTB感染者中60岁以上患者,外地户籍患者,初治患者比例较2009年有所增加,差异有统计学意义(χ^(2)=36.952、7.054、19.719,P值均<0.05)。2019年异烟肼、利福平、乙胺丁醇、卷曲霉素耐药率均低于2009年,差异均有统计学意义(χ^(2)=7.526、4.165、45.212、10.178,P值均<0.05)。2019年总耐药率为24.8%、耐多药率为5.3%,较2009年的31.6%、7.6%均有所下降,差异有统计学意义(χ^(2)=14.702、5.598,P值均<0.05)。结论北京市总耐药率与耐多药率均有下降,今后应在NTM与MTB的鉴别,流动人口防控,老年结核病防治,疗前药物敏感性检测等方面加以重视。Objective To analyze the changes in drug resistance of clinical isolates from tuberculosis patients in Beijing tuberculosis prevention and control institutions from 2009 and 2019.Methods Preliminary bacteria identification and drug susceptibility tests were given on the positive clinical isolates of mycobacteria from Beijing tuberculosis prevention and control institutions from 2009 and 2019.Results Among the 1554 mycobacteria positive isolates in 2009,1506 strains(96.9%)were Mycobacterium tuberculosis(MTB),and 48 strains(3.1%)were nontuberculous mycobacteria(NTM).Among the 1241 mycobacteria positive isolates in 2019,1156 strains were MTB(93.2%),and 85 strains were NTM85(6.8%).The NTM separation rate in 2019 was significantly higher than that in 2009(χ^(2)=21.530,P<0.001).In 2019,the proportion of patients over 60 years old,nolocal census register,and initial treatment patients among MTB infection patients had increased compared with 2009(χ^(2)=36.952,7.054,19.719,all P<0.05).The resistance rate of INH,RFP,EMB and Cm in 2019 was all lower than that in 2009,and the differences were statistically significant(χ^(2)=7.526,4.165,45.212,10.178,all P<0.05).The total drug resistance rate in 2019 was 24.8%and the multi-drug resistance rate was 5.3%,which decreased from 31.6%and 7.6%in 2009(χ^(2)=14.702,5.598,P<0.05).Conclusion Both the total drug resistance rate and the multidrug resistance rate in Beijing have declined.In the future,attention should be paid to the identification of NTM and MTB,the prevention and control of floating population,the prevention and treatment of tuberculosis in the elderly,and the detection of drug sensitivity before treatment.

关 键 词：结核抗多种药物性 数据说明统计 北京市 

分 类 号：R446.5[医药卫生—诊断学]