2016-2021年海口市新涂阳肺结核流行病学调查及耐药性监测

Epidemiological survey and drug resistance surveillance of newly smear-positive pulmonary tuberculosis in Haikou,from 2016 to 2021

目的分析海口市流动人口新涂阳肺结核流行病学特征,为该地区结核病的防控工作提供理论指导。方法回顾性分析2016—2021年海口市流动人口新涂阳肺结核患者的临床资料,收集患者痰液,采用3D全自动快速培养法对结核分枝杆菌进行分离培养及鉴定,用比例法对分离的结核分枝杆菌进行抗结核药物的药敏试验,统计新涂阳肺结核患者结核分枝杆菌检出情况及新涂阳肺结核患者治疗转归。结果新涂阳肺结核患者中年龄30~60岁占比最高,为52.65%;男性占比为64.58%,高于女性。2016—2021年新涂阳肺结核占比呈逐年下降趋势;新涂阳肺结核患者职业分布前3位的是农民、工人、学生,占比分别为28.79%、24.24%、20.08%。5种痰类型中血样痰分枝杆菌检出率最高,为47.92%,粘液痰、浆液痰检出率则较低,分别为7.39%、8.52%。528株结核分枝杆菌的耐药率为18.56%,氧氟沙星、链霉素及异烟肼的耐药率较高,分别为7.95%、4.73%、2.27%。新涂阳肺结核的平均治疗成功率为94.89%,且呈逐年上升趋势。结论海口市流动人口新涂阳肺结核多发于青壮年和老年人群,职业多为农民、工人及学生,总耐药水平较低。

Objective To analyze the epidemiological characteristics of newly smear-positive pulmonary tuberculosis of the floating population in Haikou city,and to provide theoretical guidance for the prevention and control of tuberculosis.Methods The clinical data of newly smear-positive pulmonary tuberculosis patients among the floating population in Haikou city from 2016 to 2021 were retrospectively analyzed.The sputum samples of the patient were collected,and Mycobacterium tuberculosis were separated,cultured and identified by using 3D automatic rapid culture method.The ratio method was used to carry out the anti-tuberculosis drug susceptibility test of the isolated Mycobacterium tuberculosis.The detection of Mycobacterium tuberculosis and treatment outcomes of the new smearpositive pulmonary tuberculosis patients were analyzed.Results The proportion of newly smear-positive pulmonary tuberculosis patients aged 30-60 years old was the highest(52.65%).Male accounted for 64.58%,higher than female.From 2016 to 2021,the number of newly smear-positive pulmonary tuberculosis showed a decreasing trend year by year.The top three occupational distribution of newly smear-positive pulmonary tuberculosis patients were farmers,workers and students,accounted for 28.79%,24.24%and 20.08%,respectively.Among the five sputum types,the detection rate of Mycobacterium tuberculosis from blood sputums was the highest(47.92%),the detection rate of mucous and serous sputum was 7.39%and 8.52%,respectively.The drug resistance rate of 528 Mycobacterium tuberculosis strains was 18.56%,the drug resistance rates to ofloxacin,streptomycin and isoniazid were 7.95%,4.73%and 2.27%,respectively.The average treatment success rate of newly smear-positive pulmonary tuberculosis was94.89%,and showed an increasing trend year by year.Conclusion The newly smear-positive pulmonary tuberculosis of the floating population in Haikou mostly occurred in the young,middle-aged and elderly and the occupation is mostly farmers,workers and students.The overall drug resistance level was relatively low.