河南省多药耐药结核分枝杆菌对二线抗结核药物的耐药性分析

Drug resistance to second-line anti-tuberculosis drugs of multidrug-resistant Mycobacterium tuberculosis in Henan province,China

目的了解河南省肺结核患者耐药(尤其对二线药物耐药)现况及其危险因素,为制定合理的化疗方案和控制措施提供依据。方法对河南省2009年1-12月15个市(县)结核病预防治疗机构确诊的肺结核患者进行菌种鉴定和一线抗结核药物敏感性检测;经菌种鉴定为结核分枝杆菌,且对一线药物确定为多药耐药(MDR)的菌株进行二线抗结核药物敏感性检测,分析耐药结核病患者二线抗结核药物耐药谱和危险因素。结果经一线抗结核药物敏感性测定,筛选出167例MDR患者,167株MDR菌株中,34.75%对所检测的4种二线药物中任1种具有耐药性,检出泛耐药菌株19株,占11.38%;其中耐药率最高为氧氟沙星,达31.14%;3种注射类药物中,耐药率最高为卷曲霉素,达14.97%。结论河南省结核分枝杆菌的耐药情况较为严重,在结核病预防治疗工作中应给予充分重视。

OBJECTIVE To explore the drug resistance to second-line antibiotics used by tuberculosis patients in Henan,to provide a foundation for developing reasonable chemotherapy and control measures.METHODS Clinical isolated M.TB strains were tested with proportion method.And the types were identified by differential medium culture method.RESULTS Among 167 clinical MDR M.TB strains,any drug-resistance to second line drug was 34.75%,XDR was 11.38%;Among them,the resistant rate to OFX was the highest（31.14%）.Among 3 kinds of injection drugs,the resistant rate to CPM was the highest（14.97%）.CONCLUSION Clinical isolated M.TB of Henan is very serious on drug-resistant.Drug resistant TB should be given a sufficiency attention.