鄞州区结核分枝杆菌耐药性研究

Drug resistance analysis of mycobacterium tuberculosis in Yinzhou district

目的了解鄞州区肺结核患者结核分枝杆菌的耐药水平,为本区的结核病诊治提供参考依据。方法对鄞州区疾病预防控制中心2008—2009年收集的结核分枝杆菌用WHO推荐的比例法进行异烟肼(H)、利福平(R)、链霉素(S)和乙胺丁醇(E)的耐药性检测。结果 299例初复治患者的痰培养分离的结核分枝杆菌,总耐药率为30.77%,初始耐药率和获得性耐药率分别为27.48%和54.05%;耐多药率为6.69%,其中初始和获得性耐多药率分别为4.20%和24.32%。4种抗结核药物的耐药率由高到低分别为异烟肼(19.40%)、链霉素(16.05%)、利福平(9.36%)和乙胺丁醇(6.02%)。不同性别、年龄、户籍的耐药率差异无统计学意义。结论鄞州区结核病耐药形势依然严峻,应继续加强结核病的防治工作。

Objective To explore the drug resistance level of Mycobacterium tuberculosis （MTB） ,and to pn）vidc evidencc for the control of tubcrculosis（TB）. Methods Proportion method was uscd for drug susceptibility testing of isuniazid （ INH）, rifampicin （RFP） , streptomycin （SM） and cthambutol （EMB） according to the WtlO guidelines for Surveillance of Drug Resistance in Tuberculosis. Results The resistant rate to any drug was 30.77% in all MTB isolatcs, according to cases of 299 sputum culture of Mycobactcfium tuberculosis, 27.5% in 262 new cases and 54. 1% in 37 previously treated cases, respectively. Multi - drug rcsistant rate （MI）R） was 6.7%. Initial and acquired MDR was 4. 2% and 24.3% ,respectively. Drug resistance rate of 1Ntt, SM, RFP, and EMI3 from high to low was 19.4%, 16. 1%, 9.4% and 6.0%, respectively. The drug resistance rate did not show significant differencc among different gcndcrs, age and domicile groups （ P〉 0. 05 ）. Conclusion The results show that thc situation of TB drug - resistance is severe in Yinzhou district of Ningbo City. The prevention and control of TB should be strengthened.