浙江省丽水市结核病耐药性监测结果分析

Surveillance of drug resistance of tuberculosis in Lishui,Zhejiang

目的了解浙江省丽水市结核分枝杆菌对4种一线抗结核药物的耐药情况,为本市耐药结核病疫情控制提供参考依据。方法依据耐药结核病规划管理指南(WHO),对2010-2011年丽水市所有痰培养阳性菌株进行菌型鉴定和异烟肼(INH)、利福平(RFP)、链霉素(SM)、乙胺丁醇(EMB)4种一线抗结核药物敏感性测试。结果共测定608株结核分枝杆菌的耐药性,总耐药率为22.70%,耐多药(MDR-TB)率为10.36%,对一线抗结核药的耐药顺序为INH>RFP>SM>EMB。初始耐药率和初始MDR耐药率分别为18.81%和6.72%,复治耐药率和复治MDR耐药率为45.98%和32.18%。结论丽水市肺结核总的耐药水平低于全省同期,但耐多药率远高于全省及全国同期耐药基线调查的数据,耐多药形势严峻,必须采取有效的措施加以控制。

Objective To understand drug resistance of tuberculosis （TB） to 4 kinds of first line anti-TB drugs in Lishui and provide a scientific evidence for the prevention and control of drug-resistant TB. Methods According to ＂Guidelines for management of drug-resistant tuberculosis programme＂, the drug susceptibility test of Mycobacterium tuberculosis strains collected in Lishui during 2010 - 2011 to 4 anti-TB drugs was performed. Results A total of 608 Mycobacterium tuberculosis strains were tested. The overall drug resistance rate and multi-drug-resistant rate were 22. 70% and 10. 36% respectively. The resistant rate to isoniazid was highest, followed by rifampicin, streptomycin and ethambutol. The initial drug resistant rate and initial multi-drug-resistant were 18.81% and 6. 72% respectively and the acquired drug resistant rate and acquired multi-drug-resistant were 45.98% and 32. 18%, respectively. Conclusion The overall drug resistant rate of TB in Lishui was lower than those in other areas in Zhejiang during the same period, but the multi-drug-resistant was much higher than provincial and National levels during the same period, so effective measures should be taken to control multi-drug-resistant TB.