174株耐多药结核分枝杆菌对二线抗结核药耐药情况分析

Analysis of resistance to second-line drugs in 174 strains of multidrug resistance mycobacterium tuberculosis

目的分析该院耐多药结核分枝杆菌对二线抗结核药的耐药情况,为耐多药结核病的治疗提供参考。方法采用回顾性分析法分析2011年5月至2013年5月结核病患者痰标本培养及药敏结果资料,对比分析耐多药分枝结核杆菌对5种二线药物耐药比率。结果初治耐多药结核分枝杆菌对二线耐药情况如下:耐药顺次由高到低依次为左氧氟沙星、对氨基水杨酸、丙硫异烟胺、阿米卡星及卷曲霉素的耐药比率分别为17.7%、14.5%、12.9%、8.1%及3.2%,耐两种的比率为4.8%,耐3种及3种以上的比率均为3.2%;复治情况的耐药顺次同初治顺次,但耐药比率不同,分别为50.0%、33.9%、25.9%、21.4%和16.1%,耐2种的比率为16.1%,耐3种为13.4%,耐3种以上的为12.5%。初治与复治的各种情形耐药比率比较,差异均有统计学意义(P<0.05)。结论该院耐多药结核杆菌耐药比率低于国内平均水平,复治病例耐药比率高于初治。

Objective To analyze the resistance to second-line anti-TB drugs in multi-drug resistant mycobacterium tuberculosis to provide reference for the treatment of multi drug resistant tuberculosis.Methods The data of the sputum culture and the drug sensitivity results from May 2011 to May 2013 were analyzed by the retrospective analysis method.The drug resistant rates of multi-drug resistant mycobacterium tuberculosis to 5 kinds of second-line anti-TB drug were compared.Results The resistance rates of multi-drug resistant mycobacterium tuberculosis in the initial treatment to the second-line anti-TB drugs of levofloxacin, para aminosalicylic acid,protionamide,amikacin and capreomycin in sequence from high to low were 17.7%,14.5%,12.9%,8.1%and 3.2% respectively.The resistance rate to two kinds of anti-TB drugs was 4.8%,which to 3 kinds and more than 3 kinds of an-ti-TB drugs were all 3.2%.The sequence of the drug resistance rates in the retreatment was same as to that in the initial treatment. But the resistance rates were different,which to levofloxacin,para aminosalicylic acid,protionamide,amikacin and capreomycin were 50.0%,33.9%,25.9%,21 .4% and 16.1 % respectively.The resistance rate to 2 kinds of anti-TB drugs was 16.1%,which to 3 kinds and more than 3 kinds of anti-TB drugs were 13.4% and 12.5% respectively.There were statistical significant differences in the drug resistance rate between the retreatment and the initial treatment in all various circumstances（all P 〈0.05）.Conclusion The drug resistance rate of multi-drug resistant mycobacterium tuberculosis in our hospital is lower than the average level in our country and the drug resistance rate in the retreatment is higher than that in the initial treatment.