2014—2019年重庆市肺结核耐药监测点结核分枝杆菌耐药结果分析  

Analysis of Mycobacterium tuberculosis drug resistance in drug-resistance monitoring sites in Chongqing Municipality(2014-2019)

作　　者：冯鑫 胡彦 沈静 詹建 FENG Xin;HU Yan;SHEN Jing;ZHAN Jian(Tuberculosis Reference Laboratory,Chongqing Tuberculosis Control Institute,Chongqing 400050,China)

机构地区：[1]重庆市结核病防治所结核病参比实验室,400050

出　　处：《结核与肺部疾病杂志》2021年第3期251-255,共5页Journal of Tuberculosis and Lung Disease

基　　金：重庆市科卫联合医学科研项目(2020MSXM089)。

摘　　要：目的了解重庆市结核病耐药监测点结核分枝杆菌耐药情况,为制定重庆市结核病防治方案提供参考。方法对重庆市耐药监测点(丰都县和奉节县)2014—2019年期间涂阳患者953例,进行异烟肼(INH)、利福平(RFP)、链霉素(Sm)、乙胺丁醇(EMB)、卡那霉素(Km)和氧氟沙星(Ofx)共6种药物的敏感性试验,并对耐药情况进行统计分析。结果在953例结核病患者中,初治患者797例(83.63%,797/953),复治患者156例(16.37%,156/953)。初治患者耐药率为13.30%(106/797),复治患者耐药率为24.36%(38/156),总耐药率为15.11%(144/953)。2014—2019年复治患者INH、RFP和Sm的耐药率分别为13.46%(21/156)、9.62%(15/156)和12.18%(19/156),均高于相应初治患者的耐药率[6.65%(53/797)、3.51%(28/797)和6.90%(55/797)],差异均有统计学意义(χ^(2)=8.452,P=0.004;χ^(2)=11.276,P=0.001;χ^(2)=5.076,P=0.024)。结论重庆市结核病耐药监测点复治患者耐药率高于初治患者,结核病管理实施"三位一体"后耐药情况得到了一定的控制。Objective To investigate the situation of Mycobacterium tuberculosis drug resistance in the tuberculosis drug resistance monitoring sites in Chongqing Municipality and provide reference for formulating future TB control policy.Methods The information of 935 tuberculosis patients from the two surveillance sites(Fengdu county and Fengjie County)of Chongqing from 2014 to 2019 were collected.Mycobacterium tuberculosis complex isolates from those patients were tested for drug resistance of isoniazid(INH),rifampicin(RFP),streptomycin(Sm),ethambutol(EMB),ofloxacin(Ofx)and kanamycin(Km).Results Among 953 Mycobacterium tuberculosis complex isolates,797 strains(83.63%)were isolated from newly treated patients and 156(16.37%)were from re-treated patients.Drug resistance rate among new and retreated patients were 13.30%(106/797)and 24.36%(38/156)respectively,and the total drug resistance rate was 15.11%(144/953).The drug resistance rates of INH,RFP and Sm in re-treated patients from 2014 to 2019 were 13.46%(21/156),9.62%(15/156)and 12.18%(19/156),respectively,which were significantly higher than those in the new patients(6.65%(53/797),3.51%(28/797)and 6.90%(55/797)),with statistical significance(χ^(2)=8.452,P=0.004;χ^(2)=11.276,P=0.001;χ^(2)=5.076,P=0.024).Conclusion The drug resistance rate of the retreated patients was higher than that of the newly treated patients in Chongqing tuberculosis drug resistance surveillance sites,and the drug resistance was controlled to a certain level after the implementation of"trinity of tuberculosis care provider"in tuberculosis management.

关 键 词：分枝杆菌 结核 抗药性 监测 重庆市 

分 类 号：R446.5[医药卫生—诊断学] R521[医药卫生—临床医学]