2021—2023年长沙市各区县结核病患者分布及耐药性分析  

Distribution and drug resistance analysis of tuberculosis in various districts and counties of Changsha,2021-2023

作　　者：罗莉 石国民[1] 潘建华[1] 谭爱春 马小华[1] LUO Li;SHI Guo-min;PAN Jian-hua;TAN Ai-chun;MA Xiao-hua(Department of Laboratory medicine,Changsha Central Hospital,Changsha,Huhan 410004,China)

机构地区：[1]长沙市中心医院检验科(南华大学附属长沙中心医院),湖南长沙410004

出　　处：《现代预防医学》2024年第24期4512-4516,4535,共6页Modern Preventive Medicine

基　　金：湖南省自然科学基金项目(2021JJ70130);湖南省卫健委科研项目(D202303086260)。

摘　　要：目的分析2021—2023年长沙各区县耐药监测点分离的结核分枝杆菌耐药现状,为结核病的精准防控提供参考。方法收集2021—2023年长沙各区县定点医疗机构送检的阳性标本,连同患者基本信息一起送至本院实验室做结核药敏试验。采用比例法对所有标本进行药敏试验,药物包括RFP、INH、EMB、SM、OFX、PAS、TH、KM等8种药物,χ2检验对定性资料进行分析。结果本次分离的3037例菌株中,全敏菌株2534例,耐药菌株503例,总耐药率为16.56%,其中,单耐药菌株316例,耐药率为10.41%;耐多药菌株81例,耐药率为2.67%,多耐药率为106例,耐药率为3.49%;任一药物耐药顺位分别为INH、SM和RFP,分别为9.02%、6.98%和3.65%,耐多药中排行前三分别为INH+RFP(0.66%)、INH+RFP+SM(0.4%)和INH+RFP+SM+EMB(0.36%),多耐药排行前三分别为INH+SM(1.15%)、INH+TH1321(0.4%)和INH+EMB(0.2%)。此外,2021—2023年间长沙地区结核分枝杆菌对RFP、EMB和TH1321药物耐药性呈逐年下降趋势(P<0.05),但长沙城区患者总体耐药率显著高于其他区县。结论与其他省市相比,长沙地区结核病患者总体耐药率偏低,但长沙城区结核耐药率显著高于其他区县,应该引起相关部门的高度重视。Objective To investigate the status of drug resistance of Mycobacterium tuberculosis(M.tuberculosis)isolated from drug resistance monitoring stations in Changsha from 2021 to 2023,and to provide reference for the control effect of drug-resistant tuberculosis.Methods The positive specimens from designated medical institutions in Changsha were collected and sent to our hospital together with the basic information of patients for further M.tuberculosis drug susceptibility test.Drug susceptibility tests were performed on all samples by proportional method,including 8 drugs,such as RFP,INH,EMB,SM,OFX,PAS,TH,KM,etc,and the qualitative data were analyzed byχ2 test.Results Among the 3037 isolates,2534 were fully sensitive and 503 were drug-resistant,and the total drug resistance rate was 16.56%.Among them,316 were single drug resistant,and the drug resistance rate was 10.41%.There were 81 multi-drug resistant strains(2.67%)and 106 poly-drug resistant strains(3.49%).The drug resistance sequences of any drug were INH,SM and RFP,9.02%,6.98%and 3.65%,respectively.The top three of multi-drug resistant patterns were INH+RFP(0.66%),INH+RFP+SM(0.4%)and INH+RFP+SM+EMB(0.36%),respectively.The top three poly-drug resistant patterns were INH+SM(1.15%),INH+TH1321(0.4%)and INH+EMB(0.2%),respectively.In addition,from year of 2021 to 2023,the resistance of M.tuberculosis to RFP,EMB,and TH1321 drugs in Changsha area showed a decreasing trend year by year(P<0.05),but the overall resistance rate of patients in Changsha urban area was significantly higher than that in other districts and counties.Conclusion Compared with other provinces and cities,the overall drug resistance rate of tuberculosis patients in Changsha is low,but the drug resistance rate of tuberculosis in Changsha urban area is significantly higher than that in other districts and counties,which should arouse the attention of relevant departments.

关 键 词：长沙地区 结核病 耐药 监测 

分 类 号：R521[医药卫生—内科学]