晋城地区结核分枝杆菌耐药性分析

Analysis of drug resistance of Mycobacterium tuberculosis in Jincheng

目的 了解晋城地区肺结核病患者结核分枝杆菌耐药情况,为选择更为有效、科学、合理的抗结核药物治疗,并为耐药结核病的预防控制提供依据.方法 对2015年10月至2016年10月确诊的活动性肺结核涂阳患者行痰培养和比例法行药物敏感试验,采用χ2检验对所得比率进行统计分析.结果 共分离出合格结核分枝杆菌（MTB）菌株162株,总耐药率为20.99%（34株）,低于2010年全国第五次流调结果（36.8%）.单耐药率、多耐药率和耐多药率分别为4.3%（7/162）、4.94%（8/162）和11.11%（18/162）,耐多药率显著高于2010年全国流调结果（6.8%）,接近2011-2013年太原市某医院耐多药结核（MDR-TB）（10.81%）水平.初治患者耐药率为16.15%（21/130）,复治患者耐药率为40.63%（13/32）,差异有统计学意义（χ2=9.273,P＜0.01）.男性与女性耐药率分别为21.51%（20/93）和20.29%（14/69）,差异未见统计学意义（χ2=0.035,P＞0.05）.结论 近年晋城市的总体耐药率低于2010年全国流调平均水平,但耐多药率处于较高水平,耐多药结核依然是我市今后结核病防治工作的重点.

Objective To study the situation of drug-resistance of Mycobacterium tuberculosis in Jincheng, in order to select more effective, scientific and reasonable anti tuberculosis drugs, and to provide evidence for the prevention and control of drug-resistant tuberculosis.Methods Drug sensitivity tests were carried out by sputum culture and the proportional method in all patients. They were active pulmonary tuberculosis and sputum smear-positive from October 2015 to October 2016 in Jincheng. Statistical analysis was performed with χ2-test.Results A total of 162 strains of Mycobacterium tuberculosis （MTB） were isolated. The total drug-resistance rate was 20.99%（34 strains）, which was lower than the fifth epidemic result in 2010 for China（36.8%）. The rates of single drug resistance（SDR）, poly-drug resistance（PDR） and multi drug resistance （MDR） were 4.3%（7/162）, 4.94%（8/162） and 11.11% （18/162）. MDR was much higher than the fifth epidemic result in 2010 for China（36.8%）, but they were almost the same as the level in one hospital of Taiyuan from 2011 to 2013. The initial drug-resistance was 16.15%（21/130）, while the acquired resistance rate was 40.63%（13/32）, there was significant difference between them（χ2=9.273, P〈0.01）. The drug-resistance were 21.51%（20/93） for men and 20.29%（14/69 cases） for women, there wasn＇t significant difference between them （χ2=0.035, P〉0.05）.Conclusions The total drug resistance rate is lower than the epidemic level in 2010 for China, but MDR is higher. It is very important in drug resistance tuberculosis prevention and control in Jincheng.