吉林省初治涂阳结核病患者分离株耐药谱研究

A study on drug-resistance patterns of isolates in patients with initial smear positive tuberculosis in Jilin

目的分析吉林省初治涂阳结核病患者的耐药谱资料,为耐药结核病防治工作提供参考依据。方法采用比例法对吉林省30个耐药监测点初治涂阳结核病患者分离株,进行异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、链霉素(SM)、氧氟沙星(OFX)、卡那霉素(KM)药物敏感性试验,分析结核分枝杆菌原发性耐药情况及影响因素。结果纳入初治涂阳1 200例患者,培养阳性菌株1 175株,阳性率为97.9%;对INH、RFP、EMB、SM、OFX、KM耐药率分别为17.19%(202/1 175)、10.47%(123/1 175)、4.34%(51/1 175)、26.30%(309/1 175)、5.62%(66/1 175)、3.74%(44/1 175);原发性耐药率为58.2%。结论吉林省结核病患者的耐药率日益趋高,初治涂阳结核病耐药率高,应加强结核病耐药监测,有效预防和控制结核病及耐药结核病的产生和蔓延。

Objective To survey and analyze the data of the dug- resistance pattern of the initial smear positive tuberculosis（ TB） patients in Jilin. To provide reference for prevention and treatment of tuberculosis. Methods Using the proportion method for drug susceptibility testing of of isoniazide（ INH）,rifampicin（ RFP）,ethambutol（ EMB）,streptomycin（ SM）,ofloxacin（ OFX） and kanamycin（ KM） isolated from initial smear- positive TB patients in 30 drug resistance surveillance stations of Jilin. MTB primany drug- resistance of Mycobacterium tuberculosis and its effects were analyzed. Results Collected 1 200 cases of initial smear- positive patients,1 175 cases were cultured positive,the positive rate was 97. 9%; The drug- resistant rates of MTB to INH,RFP,EMB,SM,OFX and KM were 17. 19%（ 202 /1175）,10. 47%（ 123 /1175）,4. 34%（ 51 /1175）,26. 30%（ 309 /1175）,5. 62%（ 66 /1175）,3. 74%（ 44 /1175）; Acquired initial drug resistance rate was 58. 2%. Conclusion TB drug- resistance rate of Jilin is growing increasingly high. Drug resistance rate of Jilin initial smear- positive patients is growing increasingly high,MTB resistance surveillance should be strengthened so as to effectively prevent and control the generation and spread of drug- resistant TB.