自贡市肺结核患者结核分枝杆菌耐药性分析

Drug Resistance of Mycobacterium in Patients With Pulmonary Tuberculosis inZigong

目的分析自贡市2010-04/2011-08检出肺结核病例结核分枝杆菌的耐药性,为预防及临床治疗提供科学依据。方法通过将全市6个区县结核病监测点纳入的初、复治涂阳肺结核患者,采用比例法对异烟肼(H)、利福平(R)、乙胺丁醇(E)、链霉素(S)4种药物进行敏感性检测。结果调查符合要求对象232例,总耐药47例(20.26%),其中单耐药15例(6.47%),多耐药7例(3.02%),耐多药25例(10.78%),复治组耐药率和耐多药率明显高于初治组(P<0.05);耐药患者中耐单药顺位依次为H>R>S>E,复治组REP耐药率明显高于初组(P<0.05)。结论自贡市耐多药结核病防治工作形势依然严峻,耐多药结核病防治工作将是今后结核病防治工作的重点;既往治疗史是发生耐药结核病最重要的因素;制定合理个体化治疗方案,有助于合理用药、降低耐药率,使病例尽早康复。

Objective To indentify the drug resistant profile of pulmonary TB patients registered in Zigong be- tween April 2010 and August 2011. Methods Newly and previously treated pulmonary TB patients registered in TB dispensaries of 6 districts in Zigong were conducted sensitivity test with four 18t line - drugs of INH （ H）, RIF （R）, EMB （S） and STR （E） by proportion methods. Results Of all the eligible 232 cases, 47 was re- sistant to at least one of the 18t line - drugs, including 15 cases （6. 47% ） with mono - resistance, 7 cases （ 3.02% ） with poly - drug resistance and 25 cases （ 10. 78% ） with muhidrug resistance. The rate of total drug resistance （DR） and MDR- TB was more likely to happen in previously treated cases compared to the newly treated cases. The rank of DR - rate was H 〉 R 〉 S 〉 E. Conclusion A high rate of drug resistance was ob- served among TB patients in Zigong. The drug resistance will become the major concern for the anti -TB con-trol activities crucial factor in the occurrence of drug resistance of TB.