贵州地区结核分枝杆菌对一线抗结核药物的耐药情况  

Drug resistance patterns of Mycobacterium tuberculosis to first-line anti-tuberculosis drugs in Guizhou area

作　　者：叶扬 吴嘉 王明栋 邓微 任婷婷 YE Yang;WU Jia;WANG Mingdong;DENG Wei;REN Tingting(Department of Clinical Biochemistry,School of Clinical Laboratory Science,Guizhou Medical University,550004,China)

机构地区：[1]贵州医科大学医学检验学院临床生物化学教研室,贵阳550004 [2]贵州医科大学医学检验学院感染科教研室,贵阳550004 [3]贵阳市公共卫生救治中心,550004

出　　处：《传染病信息》2025年第2期155-159,共5页Infectious Disease Information

基　　金：贵州省科技计划项目(LC[2024]056)。

摘　　要：目的了解贵州地区结核分枝杆菌临床分离株对一线抗结核药物的药敏情况。方法收集2022年8月至2023年6月贵阳市公共卫生救治中心的300株结核分枝杆菌临床分离株,使用Bactec-MGIT960分枝杆菌检测系统检测一线抗结核药物的敏感结果,并进行统计分析。结果300株结核分枝杆菌临床分离株中,分离自初治患者菌株159株,分离自复治患者菌株141株,分离自男性患者菌株82株,分离自女性患者菌株42株;总耐药率为41.33%,分离自初治患者的菌株耐药率为33.33%,分离自复治患者的菌株耐药率为50.35%;耐多药率为13.00%,分离自初治患者的菌株耐多药率为7.55%,分离自复治患者的菌株耐多药率为19.15%。在一线抗结核药物中,异烟肼耐药率最高,为31.00%,乙胺丁醇耐药率最低,为14.67%。与女性患者相比,男性患者的耐药率较高。不同年龄组患者分离结核分枝杆菌耐药率比较,以30~<60岁年龄组耐药率最高,各年龄组总耐药率差异存在统计学意义(χ^(2)=12.304,P=0.002)。复治患者的一线抗结核药物的耐药率均高于初治患者。链霉素、乙胺丁醇在耐多药分离株中的耐药率高于在耐药分离株中的耐药率,吡嗪酰胺在耐多药分离株中的耐药率与在耐药分离株中的耐药率无明显差异。结论贵州地区结核分枝杆菌的药敏情况较为复杂,耐药率、耐多药率均较高,在复治患者中耐药情况更为严重,男性患者耐药率较女性患者耐药率高,并且以30~<60岁年龄组耐药率最高。因此,应加强结核病的防治宣传力度,加强耐药高危人群的筛查,制定合理的治疗方案,规范临床合理用药,严格管理患者,完善结核病防治工作,以减少耐药结核病的产生。Objective To understand the general drug susceptibility situation of clinical isolates of Mycobacterium tuberculosis to first-line antituberculosis drugs in Guizhou.Methods Three hundred clinical Mycobacterium tuberculosis isolates from August 2022 to June 2024 at the Guiyang Public Health Treatment Center were collected,and the Bactec-MGIT960 system was used to test their drug susceptibility.The results of their susceptibility to first-line antituberculosis drugs were counted and analyzed.Results Of the 300 clinical Mycobacterium tuberculosis isolates.One hundred and fifty-nine strains were separated from first-treatment patients 141 strains were separated from retreatment patients,82 strains were separated from males and 42 strains were separated from females.The total drug resistance rate was 41.33%,33.33%of that was in primary treatment patients 50.35%was in retreatment patients,and the multidrug resistance rate was 13.00%,7.55%was in first-treatment patients and 19.15%of that was in retreatment patients.Among all Mycobacterium tuberculosis isolates.Isoniazid has the highest resistance rate,accounting for 31.00%,and the resistance rate of ethambutol was the lowest,accounting for 14.67%.Compared with female patients,male patients had a higher drug resistance rate.Among the 3 age groups,30-60 years old had the highest incidence,and the total drug resistance rate of all age groups was significantly different(χ^(2)=12.304,P=0.002).Compared with first-treatment patients,the resistance rate of all first-line antituberculosis drugs in retreatment patients is higher than in first-treatment patients.The resistance rate of streptomycin and ethambutol in multidrug-resistant isolates was higher than those in drug-resistant isolates,and there was no significant difference in the resistance rate of pyrazinamide in multidrug-resistant isolates and drug-resistant isolates(P=0.078).Conclusions The drug susceptibility situation of Mycobacterium tuberculosis in Guizhou is complex,and the drug resistance rate and multidrug resi

关 键 词：结核分枝杆菌 药物敏感性 Bactec-MGIT960 异烟肼 利福平 吡嗪酰胺 

分 类 号：R52[医药卫生—内科学]