2010-2014年浙江省绍兴市涂阳肺结核患者耐药特征分析

Drug resistance in smear positive tuberculosis patients in Shaoxing,Zhejiang,2010-2014

目的了解绍兴市肺结核病患者耐药状况及影响因素,为制定耐药结核病防制策略提供科学依据。方法对2010 2014年期间在绍兴市就诊的涂阳肺结核病患者的痰标本进行培养,经鉴定为结核分枝杆菌的菌株进行异烟肼(isoniazid,INH)、利福平(rifampicin,RFP)、链霉素(streptomycin,SM)和乙胺丁醇(ethambutal,EMB)4种一线抗结核药物的敏感性测试。结果检测的3042份结核分枝杆菌阳性标本总耐药率为11.28%,其中,初治患者耐药率9.11%,复治患者耐药率26.60%,耐药顺位由高到低依次为INH、SM、RFP和EMB;耐多药率为5.33%,初治患者耐多药率2.96%,复治患者耐多药率22.07%。结论绍兴市肺结核耐药率总体低于全国水平,但复治患者耐多药率较高,应加大耐多药结核病防控措施。

Objective To understand the drug resistance in smear positive tuberculosis（ TB） patients in Shaoxing,Zhejiang province,and provide evidence for the prevention and control of TB. Methods Mycobacterium tuberculosis strains were isolated from the sputum samples of the TB patients receiving treatment in the hospitals in Shaoxing from 2010 to 2012. The drug susceptibility test of the isolated strains to isoniazid（ INH）,rifampicin（ RFP）,ethambutal（ EMB） and streptomycin（ SM） was conducted. Results In the 3042 sputum culture-positive cases,the overall drug resistant rate was 11. 28%. In newcases,the overall drug resistant rate was 9. 11%,and in retreated cases,the overall drug resistant rate was 26. 60%. The resistant rate to INH was the highest,followed by SM,RFP and EMB. The overall multi-drug resistant rate was 5. 33%. In newcases,the multi-drug resistant rate was 2. 96%,and in retreated cases,the multi-drug resistant rate was 22. 07%.Conclusion In Shaoxing,the overall drug resistant rate of TB was lower than national level,but multi drug resistance was still very serious in retreated TB patients. It is necessary to strengthen the prevention and control of multi drug resistant TB.