锑矿工结核病传播及危险因素调查

Investigation on spread and risk factors of tuberculosis in antimony miners

目的了解锑矿工肺结核感染率及感染的危险因素。方法采用整群抽样方法,对263例锑矿工肺结核患者进行结核分枝杆菌的菌株鉴定和药敏试验。基因分型采用12位点结核分枝杆菌散在分布重复单元和多位点串联重复序列;采用2检验评估结核传播的危险因素。结果锑矿工肺结核的感染率为9.8%(472/4 831);纳入研究的263例患者中,175例成簇,成簇率为66.5%,近期传播率最低估计值为53.2%。治疗失败、工龄大于10年、菌株多重耐药及痰涂片阳性的锑矿工肺结核传播率较高。结论锑矿工结核分枝杆菌具有成簇性,其菌株毒力更强、传播率高,治疗效果、矿龄、菌株耐药性及痰涂片结果是影响肺结核传播的重要危险因素。

Objective To explore the infection rate of tuberculosis（ TB） and its risk factors in antimony miners. Methods With cluster sampling method,the strains identification and drug sensitive test were performed in Mycobacterium tuberculosis（ MTB） of 263 TB patients in antimony miners. The method of 12 sites mycobacterial interspersed repetitive unit and variable number of tandem repeat wre used to determine the genetic type of MTB. Risk factors of TB spread were assessed by chi-square test. Results The TB infection rate in antimony miners was 9. 8%（ 472 /4 831）; among 263 TB cases,175 cases were found clustered the clustering rate was 66. 5%,the least estimated recent TB spread rate was53. 2%. High TB spread rate was found in the antimony miners with failed treatment,length of service longer than 10 years,multidrug-resistant bacterial strains,and positive sputum smear. Conclusion The MTB of antimony miners showed the clustering feature and the bacterial strains had strong toxicity and higher spreading rate. The major risk factors affecting TB spread were therapeutic effect,length of service,drug resistant bacterial strain and sputum smear result.