宁夏地区结核分枝杆菌耐药情况调查

Survey of drug-resistant Mycobacterium tuberculosis in Ningxia

目的 了解宁夏地区MTB耐药情况,为制定宁夏结核病防治策略提供科学依据.方法 2013年4月至2014年4月在宁夏全区范围内开展MTB耐药情况调查.对所有确诊的活动性肺结核患者均采用痰培养和比例法进行药物敏感试验.用x2检验方法对所得率进行统计分析.结果 本次普查共纳入病例2 369例,男1 177例,女1 192例;年龄12 ～ 80岁,平均（51 ±21岁）;汉族1 176例,回族844例,其他民族349例;初治肺结核2 255例,复治肺结核114例;2 369例患者中共分离出合格MTB菌株665株,总耐药率为26.6％（177株）,初始耐药率为20.2％（119/590株）,获得耐药率为77.3％（58/75株）;单耐药率为11.7％（78/665株）,耐多药率为7.8％（52/665株）,多耐药率为7.1％（47/665株）.不同地区、民族、耐药菌分型、初治及复治的耐药率比较差异有统计学意义（x2值分别为15.362、5.888、7.887和1.113,均P＜0.05）.结论 初诊肺结核的患者单耐药、复治肺结核患者耐多药和少数民族聚集地区的耐药结核病防控将是我区今后结核病防治工作的重点.

Objective To study the status of drug-resistant Mycobacterium tuberculosis in Ningxia,and therefore to provide scientific data for tuberculosis control in this area.Methods Drug sensitivity tests were carried out by sputum culture and the proportional method in all patients with active pulmonary tuberculosis from April 2014 to April 2013 in Ningxia.Statistical analysis was performed with x2-test.Results This survey included 2 369 cases （1 177 males,1 192 females）,aged 12 to 80 years （mean 51 ±.21）.There were 1 176 patients of Han nationality,844 Hui nationality,and 349 other nationalities.Cases with initial treatment were 2 255,and those with retreatment were 114.A total of 665 isolates were obtained.The total drug resistance rate was 26.6％ （177 cases）;the initial drug resistant rate was 20.2％ （119/590 cases）,while the acquired resistant rate was 77.3％ （58/75 cases）.The rate of single drug resistance was 11.7％ （78/665 cases）,MDR was 7.8％ （52/665 cases）,and multiple drug resistance was 7.1％ （47/665 cases）.In different areas,ethnic minority,drug-resistant bacterial classification,the rate of initial and retreatment resistance were statistically different.Conclusions Drug resistant tuberculosis prevention and control in Ningxia should be focused on newly diagnosed single drug-resistant cases,retreatment multipledrug resistant cases,and drug resistant cases in minority areas.