陕西省秦巴项目地区结核菌耐药监测分析

Analysis of Drug Resistance Surveillance on Tuberculosis in Qinba Region of Shanxi

目的:了解陕西秦巴地区结核菌耐药情况,为结核病控制提供科学依据、今后耐药监测提供经验。方法:采用《结核菌耐药性监测方案》规定的方法进行监测,对2005年10个项目县新登记的初、复治涂阳肺结核病例的痰标本进行分离培养和药敏试验。结果:共入选360例,培养阳性283例,其中结核分枝杆菌复合群273例,非结核分枝杆菌10例。总耐药率为28.9%,初始耐药率为24.6%,获得性耐药率为39.0%;耐多药率(MDR)为2.6%。结论:初始耐药率高于2000年全国流行病学调查结果,获得性耐药率低于2000年全国流行病学调查结果。提示应进一步扩大监测范围,加强病人的用药指导与治疗管理。

Objective： To realize the magnitude and pattern of drug resistant tuberculosis in qinba region of shanxi and to provide the gist and experience of TB control. Method： Ten counties were selected with cluster sampling method. According to case enroll criteria, all the new smear positive cases and retreated smear positive eases during the survey period were involved and their sputum were collected for culture and drug resistant test. Result ：360 cases were selected. There were 273 Mycobacterium tuberculosis complex and 10 non-mycobacterium tuberculosis. Drug susceptibility testing against INH, RFP, SM and EMB were performed in 283 cases by proportion method. The overall drug resistance, drug resistance among new cases and retreated smear positive cases were 28.9%, 24.6% and 39.0%, and the multi-drng resistance rate was 2.6%. Conclusion：Drug resistance rate among new cases was higher than the one that came from the 2000 national epidemiology of tuberculosis survey. And the multi - drug resistance rate was lower than the one that came from the 2000 national epidemiology of tuberculosis survey, and the quality of TB management need to be strengthened.