石家庄市268例初治肺结核耐药菌株分析

Analysis on Drug-resistant Strains of 268 TB Patients with Initial Treatment in Shijiazhuang City

目的了解石家庄市2004—2008年门诊就诊初治肺结核病人的耐药情况及影响因素,为制定耐药结核病的防治对策提供参考依据。方法对2004—2008年在门诊就诊的初治肺结核病人痰培养阳性的744份痰标本进行菌型鉴定及5种抗结核药物(INH、RFP、EMB、PAS、SM)的耐药性试验。结果744份痰培养阳性,平均耐药率为36.02%,耐多药率为11.69%;5种抗结核药物的耐药顺位H(21.25%)、R(20.02%)、S(19.62%)、E(11.29%)、P(10.48%),以耐单药和耐2种药物为主(57.84%);各年龄组不同性别耐药率不存在差别(P>0.05),结核病患者耐药的高峰年龄在20～39岁。结论加强医防合作,采取得力措施落实短程化疗(DOTS)管理,规范化疗方案是减少耐药发生的有效措施。

[ Objective] To understand drug-resistance and influencing factors of tuberculosis （ TB ） patients with initial treatment in Shijiazhuang City during 2004--2008, and provide evidence for developing control measures. [ Methods ] A total of 744 samples of sputum from TB patients with initial treatment were collected for identification of bacteria and resistance test of 5 kinds of antitubercu- lotics （INH,RFP,EMB,PAS,SM）. [ Results] Of 744 samples of sputum culture-positive, the average resistance rate was 36.02%, multi-drug resistance rate was 11.69% ; the drug-resistance of 5 kinds TB drugs were H （21.25%）, R （20.02%）, S（ 19.62% ） , E （ 11.29% ） , P （ 10.48% ）. The main drug-resistance mode was resistance to single drug or to 2 kinds of drug （ 57.84% }. The differences of resistance between genders or between age groups were not significant （ P 〉 0.05 }. The peak age of TB patients with drug resistance was 20 - 39 years old. [ Conclusion ] Strengthening medical anti-cooperation, adopting DOTS management, and standardizing chemotherapy plan are effective ways to reduce drug resistance.