2004～2009年我中心结核分枝杆菌临床株耐药趋势

Drug resistance of clinical mycobacterium tuberculosis during 2004～2009

目的探讨重庆市公共卫生医疗救治中心临床结核菌株耐药趋势。方法采用BACT/ALERT3D进行各种临床标本的分枝杆菌分离培养,L-J绝对浓度间接法进行分枝杆菌的初步菌种鉴定和药物敏感试验。结果 1916株结核分枝杆菌在11种药敏结果中耐一种药物的耐药率为62.8%(1204株),耐多药(MDR)24.1%(462株),广泛耐药(XDR)4.0%(76株)。结论重庆市公共卫生医疗救治中心就诊的结核病患者结核分枝杆菌株的总耐药率、MDR和XDR等明显高于全国结核病耐药性基线调查结果,其高耐药趋势与该中心收治基层和周边地区转送难复治结核较多有较密切关系。

Objective To investigate the clinical drug resistance of Mycobacterium tuberculosis in our center.Methods Mycobacterium tuberculosis was cultured by BACT/ALERT3D.L-J absolute concentration method was used for Mycobacterium tuberculosis strain identification and drug sensitivity test.Results Among the 1916 Mycobacterium tuberculosis strains,at least one-resistance drug was 62.8%（1204 strains）,MDR was 24.1%（462 strains）,XDR was 4.0%（76 strains）.Drug resistance rates showed： INH was 40.5%（776 strains）,RFP was 33.8%（647 strains）,RFT was 32.9%（630 strains）,SM was 24.5%（469 strains）,EMB was 24.5%（469 strains）,DPC was 24.1%（462 strains）,LVFX was 16.4%（315 strains）,PAS was 13.8%（265 strains）,1321TH was 13.3%（255 strains）,CPM was 8.6%（164 strains）,KM was 7.6%（145 strains）.Conclusion The total drug resistance rates,MDR and XDR in our centers are obviously higher than the baseline data from national investigation.The high drug resistance tendency has close related to the difficulty of re-treatment tuberculosis which collected from grassroots and the surrounding areas.Clinical characteristics the drug resistance needs further research.