唐山市247株结核分枝杆菌耐药情况分析  

Analysis of drug resistance of 247 strains of Mycobacterium tuberculosis in Tangshan City

作　　者：刘海涛[1] 田杰[1] 赵俊鹏[2] 韩云艳 周志枫 李世明[1] LIU Hai-tao;TIAN Jie;ZHAO Jun-peng;HAN Yun-yan;ZHOU Zhi-feng;LI Shi-ming(Department of Clinical Laboratory,the Fourth Hospital of Tangshan,Hebei 063000,China;不详)

机构地区：[1]唐山市第四医院检验科,河北063000 [2]唐山市疾病预防控制中心结防科

出　　处：《医学动物防制》2023年第2期150-153,158,共5页Journal of Medical Pest Control

基　　金：河北省2022年度医学科学研究重点课题计划(20221806)。

摘　　要：目的 分析唐山市结核分枝杆菌的耐药情况,为结核病患者提供精准有效的治疗方案,预防耐药结核病的发生。方法 收集2021年1-10月唐山市第七医院就诊患者的720份痰液标本进行分枝杆菌培养和鉴定,将分离到的287株结核分枝杆菌进行药敏实验,对其药敏结果进行统计分析。结果 剔除分离来自同一患者的重复菌株,共247株结核分枝杆菌的药敏结果纳入统计分析。247株菌株共分离到全部敏感株140株,总体耐药率为43.32%(107/247),一线药的耐药率为33.20%(82/247),二线药的耐药率为28.74%(71/247)。初治患者单耐药率、多耐药率、耐多药率、广泛耐药率分别为11.11%(25/225)、6.22%(14/225)、9.33%(21/225)、0.89%(2/225)。复治患者单耐药率、多耐药率、耐多药率、广泛耐药率分别为18.18%(4/22)、22.73%(5/22)、27.27%(6/22)、4.55%(1/22)。耐多药株对克拉霉素的敏感性为100.00%(27/27)、对氯法齐明的敏感性为81.48%(22/27)。多耐药株对克拉霉素的敏感性为89.47%(17/19)、对氯法齐明的敏感性为73.68%(14/19)。结论 常规抗结核药在唐山市耐药情况严重,克拉霉素和氯法齐明耐药率较低,仍需加强对结核病的诊疗规范和耐药监测。Objective To analyze the drug resistance of Mycobacterium tuberculosis in Tangshan City of Hebei Province so as to provide accurate and effective treatment for tuberculosis patients and to prevent the occurrence of drug-resistant tuberculosis.Methods A total of 720 sputum samples from patients admitted to the Seventh Hospital of Tangshan City from January to October 2021 were collected for Mycobacterium tuberculosis culture and identification.There were 287 strains of Mycobacterium tuberculosis isolated for drug sensitivity test.Retrospective analysis of the results of drug sensitivity was conducted.Results The repeated strains from same patients were excluded and isolated, and the drug susceptibility results of 247 strains of Mycobacterium tuberculosis were included in statistical analysis.A total of 140 sensitive strains were isolated from the 247 strains, and the overall resistance rate was 43.32%(107/247).The resistance rate of first-line drugs was 33.20%(82/247),and the resistance rate of second-line drugs was 28.74%(71/247).The mono-drug resistant(MR) rate, poly-drug resistant(PR) rate, multi-drug resistant(MDR) rate and extensive-drug resistant(XDR) rate of newly diagnosed patients were 11.11%(25/225),6.22%(14/225),9.33%(21/225) and 0.89%(2/225),respectively.The mono-drug resistant(MR) rate, poly-drug resistant(PR) rate, multi-drug resistant(MDR) rate and extensive-drug resistant(XDR) rate of retreated patients were 18.18%(4/22),22.73%(5/22),27.27%(6/22) and 4.55%(1/22),respectively.The sensitivity of multi-drug resistant strains to clarithromycin was 100.00%(27/27) and the sensitivity to clofazimine was 81.48%(22/27).The sensitivity of poly-drug resistant strains to clarithromycin was 89.47%(17/19) and the sensitivity to clofazimine was 73.68%(14/19).Conclusion The drug resistance of conventional anti-tuberculosis drugs is serious in Tangshan City.The drug resistance rates of clarithromycin and clofazimine are low.It is still necessary to further standardize the diagnosis and treatment of tuberculosis and

关 键 词：结核分枝杆菌 耐药结核病 耐多药结核病 耐药率 克拉霉素 氯法齐明 分析 

分 类 号：R378.911[医药卫生—病原生物学]