上海市1985～1995年结核分支杆菌原发耐药性观察

Primary drug-resistance of Mycobacterium tuberculosis in Shanghai, 1985～1995

目的 了解上海市 1985～ 1995年结核分支杆菌原发耐药性。方法 采用绝对浓度的间接法进行 6种抗结核药物的耐药性测定。结果 耐SM、INH、RFP、PAS和KM率由 1985～ 1986年的10 2 %、5 2 %、4 8%、5 6 %和 3 9%下降至 1994～ 1995年的 4 8%、4 8%、4 3%、3 6 %和 2 6 % ,耐EMB率由 1 3%上升至 3 3% ;总耐药率由 1985～ 1986年的 15 6 %下降至 1994～ 1995年的 8 2 % ;耐 1药、2药、3药、4药、5药和 6药的耐药率分别由 5 9%、4 6 %、2 5 %、1 5 %、0 4%和 0 8%降至 1 9%、3 5 %、1 2 %、1 2 %、0 1%和 0 4%。耐INH、RFP率 1992～ 1993年为 1 9% ,1994～ 1995年为 2 4%。结论 上海市结核分支杆菌原发耐药性 10年来呈下降趋势 ,但耐多药菌株仍占一定比例。

Objective To evaluate the problem of antituberculosis drug resistance in Shanghai, 1985～1995 Method All of the strains of M tuberculosis from new patients with pulmonary tuberculosis were tested for resistance to INH, RFP, EMB, SM, PAS, and KM by the absolute concentration method on Lowenstein Jensen medium Results The rates of primary drug resistance to SM, INH, RFP, PAS, and KM were 10 2%, 5 2%, 4 8%, 5 6%, and 3 9% respectively in 1985, and decreased to 4 8%, 4 8%, 4 3%, 3 6%, and 2 6% in 1995, while the rate of drug resistance to EMB was 1 3% in 1985, and increased to 3 3% in 1995 The primary resistance rate to one or more drugs was 15 6% in 1985 and 8 2% in 1995 The resistance rates to one, two, three, four, five, and six drugs were 5 9%, 4 6%, 2 5%, 1 5%, 0 4%, and 0 8% respectively in 1985, and decreased to 1 9%, 3 5%, 1 2%, 1 2%, 0 1%, and 0 4% in 1995 The resistance rates to INH and RFP were 1 9% in 1992～1993,2 4% in 1994～1995 Conclusion The primary drug resistance of M tuberculosis in Shanghai, 1985～1995, was in a trend of decline, but multi drug resistance is still seriously existed