馆陶县2012至2014年初治涂阳肺结核患者分枝杆菌培养及耐药

Mycobacterium culture and medicine resistance of patients with initial treatment of smear positive pulmonary tuberculosis from 2012-2014 in Guantao County

目的调查本县初治涂阳肺结核患者分枝杆菌培养及耐药情况,为分析结核病的防治措施提供依据。方法选择2012-2014年于本县医院诊治的初治涂阳肺结核患者,在对其进行分枝杆菌培养的基础上,将阳性菌株送至本市相关实验室进行菌种鉴定以及药物敏感性分析。结果本研究中共收治562例初治涂阳肺结核患者,其中性别比男︰女=2.23︰1,平均年龄(41.2±3.7)岁;菌群类别:结核分枝杆菌492株(87.54%),非结核分枝杆菌70株(12.46%)。敏感株为448株(79.72%),耐药菌株为114株(20.28%),其中耐多药菌株为36株(6.41%),单耐药患者以耐链霉素(S)为常见(5.34%),其次为耐异烟肼(称H)(4.63%)。多耐药中以至少耐异烟肼、链霉素(HS)为常见(22/562,3.91%),其次为耐异烟肼、利福平(耐HR)(3.73%)。多耐药中耐两药者16例(2.85%),耐3药者17例(3.02%),耐4药者3例(0.53%)。耐药顺序为S>H>R>E。结论中青年男性为肺结核防治的高危人群,需要对其进行密切防控。本县结核分枝杆菌复合群菌株的耐药率虽不高,但初治涂阳患者存在耐多药,需要进一步改进结核病的防控工作。

Objective To investigate the situation of Mycobacterium culture and drug resistance of patients with initial treatment smear positive pulmonary tuberculosis in Guantao County, and to provide basis for pulmonary tuberculosis prevention and control measures. Methods Patients with initial treatment smear positive pulmonary tuberculosis treated in our county were selected, the Mycobacterium from the cases were cultured, positive strains were sent to in our city and strain identification as well as drug sensitivity were analyzed, respectively. Results Total of 562 cases with initial treatment smear positive pulmonary tuberculosis were collected, male：female = 2.23︰1, the average age was（41.2 ± 3.7） years old. Bacteriologic colony： Mycobacterium tuberculosis 492（87.54%） strains, nontuberculosis Mycobacteria 70（12.46%） strains. There were 448（79.72%） sensitive strains, 114（20.28%） resistance strains and 36（6.41%） multi-drug resistance strains. Among the patients with single resistance, most were streptomycin medicine resistance（5.34%）, the second were isonicotinyl hydrazide resistance（4.63%）. Among the patients with multi-drug resistance, most were isonicotinyl hydrazide and streptomycin resistance（22/562, 3.91%）, the second were isonicotinyl hydrazide and rifampicin resistance（3.73%）. Among the patients with multi-drug resistance, 16（2.85%） cases with 2 medicines resistance, 17（3.02%） cases with 3 medicines resistance, 3（0.53%） cases with 4 medicines resistance. The resistance drug order was S〉 H〉 R 〉E. Conclusions Young and middle-aged male were high risk group of pulmonary tuberculosis prevention and control, who should be administered closely. Pulmonary Mycobacterium complex strain＇s resistance wasn＇t high, but there existed initial treatment smear positive patients with multi-drug resistance, so pulmonary tuberculosis prevention and control measures should be improved.