2014—2023年吉林省耐药监测点结核耐药情况及相关因素分析  

Analysis of tuberculosis drug resistance and related factors in Jilin Province drug resistance monitoring points from 2014 to 2023

作　　者：刘昕 马莹聪 王岙[2] 齐鹏 朱琳莹 张立夫[2] 杨帆 张炜煜[3] 王慧[3] LIU Xin;MA Yingcong;WANG Ao;QI Peng;ZHU Linying;ZHANG Lifu;YANG Fan;ZHANG Weiyu;WANG Hui(Jilin Provincial Tuberculosis Prevention and Control Institute(Af filiated Hospital of Jilin Provincial Tuberculosis Prevention and Control Institute),Jilin Changchun 130062,China;Jilin Provincial Health Monitoring and Inspection Center,Jilin Changchun 130062,China;Jilin Provincial Center For Disease Control And Prevention(Jilin Provincial Academy of Preventive Medical Sciences),Jilin Changchun 130062,China)

机构地区：[1]吉林省结核病防治科学研究院(吉林省结核病防治科学研究院附属医院) [2]吉林省卫生监测检验中心 [3]吉林省疾病预防控制中心(吉林省预防医学科学院)

出　　处：《中国实验诊断学》2024年第12期1427-1432,共6页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省卫生健康科技能力提升项目(2021GW010);吉林省卫生健康科技能力提升项目(2022GW005)。

摘　　要：目的了解吉林省耐药监测点-桦甸市2014年—2023年的结核病耐药情况,为今后的结核病防治工作提供数据支持。方法选取2014—2023年桦甸市10年间纳入的结核病患者,采用比例法药敏实验进行6种药物的药物敏感性检测,采用χ2检验法及Logistic回归分析进行统计推断,对桦甸市结核病耐药情况及相关因素进行分析。结果获得结果的585株结核分枝杆菌中耐药菌株279株,耐药率47.7%;初治患者耐药率46.7%,复治患者耐药率55.1%;单耐药率43.7%,初治患者单耐药率大于复治患者(22.3%比10.1%,P=0.020),差异有统计学意义;耐多药菌株85株,耐多药率30.5%,复治患者耐多药率高于初治患者(24.6%比13.2%,P=0.009),差异有统计学意义;多耐药菌株60株,多耐药率21.5%,复治患者多耐药率高于初治患者(18.8%比9.1%,P=0.012),男性患者高于女性患者(12.3%比4.1%,P=0.005),差异有统计学意义;广泛耐药菌株11株,广泛耐药率3.9%。复治病例发生结核分枝杆菌多耐药是初治病例的2.064倍(OR=2.064,95%CI:1.045~4.073);男性发生结核分枝杆菌多耐药是女性的3.019倍(OR=3.019,95%CI:1.265~7.206)。同时,桦甸市所在地区的发病率在2020年以前呈逐步下降趋势,到2023年发病率呈上升趋势。结论复治患者和男性患者中耐多药和多耐药率显著高于初治患者和女性患者,需要进一步加强对结核病特别是耐药结核病的防治工作,尤其是针对复治患者和男性患者。Objective To understand the drug resistance of tuberculosis in Huadian City,a drug resistance surveillance point in Jilin Province,from 2014 to 2023,so as to provide data support for future tuberculosis prevention and control.Methods The tuberculosis patients included in Huadian City in the ten years from 2014 to 2023 were selected,and the drug sensitivity of six drugs was tested by the proportional method drug sensitivity test.Theχ2 test and logistic regression analysis were used for statistical inference,and the drug resistance and related factors of tuberculosis in this area were analyzed.Results Results among the 585 strains of Mycobacterium tuberculosis,279 strains were drug resistant,and the drug resistance rate was 47.7%.The drug resistance rate of newly treated patients was 46.7%,and that of re-treated patients was 55.1%.The single-drug resistance rate was 43.7%,and the single-drug resistance rate of newly treated patients was higher than that of retreatment patients(22.3%vs 10.1%,P=0.020),with statistical significance;there were 85 multidrug-resistant strains,and the multidrug-resistant rate was 30.5%.The multidrug-resistant rate of retreatment patients was higher than that of initial treatment patients(24.6%vs 13.2%,P=0.009),and the difference was statistically significant;there were 60 multidrug-resistant strains,and the multidrug-resistant rate was 21.5%.The multidrug-resistant rate of retreatment patients was higher than that of initial treatment patients(18.8%vs 9.1%,P=0.012),and that of male patients was higher than that of female patients(12.3%vs 4.1%,P=0.005),with statistical significance.There were 11 strains with extensive drug resistance,and the rate of extensive drug resistance was 3.9%.The multidrug resistance of Mycobacterium tuberculosis in retreatment cases was 2.064 times higher than that in initial treatment cases(OR=2.064,95%CI:1.045~4.073).The incidence of multidrug resistance of Mycobacterium tuberculosis in men was 3.019 times higher than that in women(OR=3.019,95%CI:1.265~7.206).A

关 键 词：结核分枝杆菌 耐药 

分 类 号：R446.5[医药卫生—诊断学]