乐山市2020—2022年1496株结核杆菌耐药特征分析  

Drug resistance characteristics of 1496 strains of Mycobacterium tuberculosis in Leshan City from 2020 to 2022

作　　者：曹铸[1] 刘昕亮[1] 王颖 陈梅 CAO Zhu;LIU Xinliang;WANG Ying;CHEN Mei(Leshan Center for Disease Control and Prevention,Leshan 614000,Sichuan Province,China;Emeishan Center for Disease Control and Prevention,Leshan 614200,Sichuan Province,China;Sinopharm Holding Sichuan Pharmaceutical Co.,Ltd.,Chengdu 610000,Sichuan Province,China)

机构地区：[1]乐山市疾病预防控制中心,四川乐山614000 [2]峨眉山市疾病预防控制中心,四川乐山614200 [3]国药控股四川医药股份有限公司,成都610000

出　　处：《预防医学情报杂志》2024年第1期54-59,共6页Journal of Preventive Medicine Information

摘　　要：目的本文通过对乐山地区2020—2022年各县区送检的1496株结核分枝杆菌的耐药性进行分析,为乐山市结核病的未来防控提供重要科学依据。方法采用线性探针对乐山地区2020—2022年各县区送检的1496株结核分枝杆菌菌株进行一线药异烟肼(isoniazid,INH)和利福平(Rifampicin,RFP)耐药性检测,当菌株确认RFP耐药后,进行二线药物耐药分析。二线药物卡拉霉素(Kalamycin,K)和氧氟沙星(Ofloxacin,OFLX)使用菌株进行传代处理后采用比例法进行检测,实验操作以及结果判断按照《结核病实验室检验规程》的要求进行。结果1496株结核分枝杆菌的总体耐药率为14.83%,耐多药率为5.35%。结核病高耐药率主要分布在乐山市的边远山区和少数民族地区,人群年龄特征主要集中在20~40岁之间。一线药抗结核药物中,耐药率组合主要为RFP(2.81%)、INH+RFP(5.35%)和INH(6.68%),而二线药耐药率组合主要为K(2.11%)、OFLX(22.11%)和K+OFLX(15.79%)。初治患者和涂阴患者各种抗结核药物的耐药率普遍低于复治患者。结论乐山市各县区结核病总体耐药率和耐多药率比全国各地的耐药水平低,但在青中年人群、边远山区以及少数民族地区耐药率仍相对较高,同时复治患者中耐药率依然明显高于其他人群,这将是未来乐山市结核病防控的重中之重。Objective To analyze the drug resistance of 1496 strains of Mycobacterium tuberculosis sent for testing by various counties and districts of Leshan region from 2020 to 2022,and to provide important scientific basis for the future prevention and control of tuberculosis in Leshan City.Methods Linear probes were used to test the resistance of 1496 strains of Mycobacterium tuberculosis sent for testing by various counties and districts of Leshan region from 2020 to 2022 to the first-line drugs isoniazid(INH)and Rifampicin(RFP).After RFP resistance was confirmed,second-line drug resistance analysis was conducted.The strains were subjected to proportion method for testing with second-line drugs kalamycin(K)and ofloxacin(OFLX)after been passaged.The experimental procedures and result interpretation were carried out according to the requirements of the Laboratory Testing Procedures for Tuberculosis.Results The overall drug resistance rate of the 1496 strains of Mycobacterium tuberculosis was 14.83%,and the multidrug resistance rate was 5.35%.The high drug resistance rate of tuberculosis was mainly distributed in the remote mountainous areas and ethnic minority areas of Leshan City.The age characteristics of the population were mainly concentrated between 20 and 40 years old.Among the first-line anti-tuberculosis drugs,the combinations of resistance rate were mainly RFP(2.81%),INH+RFP(5.35%)and INH(6.68%),while the combinations of resistance rate for second-line drugs were K(2.11%),OFLX(22.11%)and K+OFLX(15.79%).The drug resistance rates of various anti-tuberculosis drugs in patients with initial treatment and smear-negative patients were generally lower than that in patients with retreatment.Conclusions The overall drug resistance rate and multidrug resistance rate of tuberculosis in counties and districts of Leshan City were lower than the national average level,but the resistance rate was still relatively high in the middle-aged and young population,remote mountainous areas and ethnic minority areas.Furthermore,the dru

关 键 词：结核病 药敏试验 耐药结核 耐多药结核 

分 类 号：R378.91[医药卫生—病原生物学]