2013年-2016年衢州市分枝杆菌菌种鉴定和耐药状况分析

Identification and drug resistance of Mycobacteria in Quzhou during 2013-2016

目的了解衢州地区分枝杆菌菌种和药敏情况,为结核病的治疗与控制提供科学依据。方法对2013年-2016年衢州市分枝杆菌菌株进行耐药性检测和菌种初步鉴定。初筛为非结核分枝杆菌(NTM)的菌株利用基因芯片技术作菌种鉴定。结果 2 487株分枝杆菌经过鉴定,159株为NTM,2 328株为结核分枝杆菌。NTM的检出率从2013年的4.84%上升到2016年的8.25%。2 328株结核分枝杆菌的总耐药率为21.43%,耐多药率为5.71%,广泛耐药率为0.52%;复治患者的总耐药率、耐多药率、广泛耐药率以及对任一药物的耐药率均明显高于初治患者;单一耐药位于前3位分别为SM、OFX、INH,多耐药顺位的前3位为INH+RIF+SM+OFX、INH+SM、INH+RIF+SM。结论衢州地区复治结核患者耐药严重,应该将复治患者作为防控的重点,预防耐药结核甚至广泛耐药结核的发生。

Objective To understand the species and drug-resistance status of Mycobacteria in Quzhou,so as to provide basis for the control and prevention of tuberculosis. Methods Mycobacterium strains were conducted for drug resistance test and strain-identification in Quzhou during 2013-2016. The primarily identified non tuberculosis Mycobacterium strains（ NTM）were conducted for further identification with gene chip. Results 159 strains of NTM and 2 328 strains of Mycobacterium tuberculosis（ MT） were detected from 2 487 strains of Mycobacterial. The detection rate of NTM increased from 4. 84% in 2013 to8. 25% in 2016. The total drug resistance rate of MT was 21. 43%,total multi-drug resistance rate was 5. 71%,the total extensive resistance rate was 0. 52%; the total drug resistance rate,total multi-drug resistance rate,total extensive resistance rate,resistant rate of any drugs in recurrent pulmonary tuberculosis patients were higher than new pulmonary tuberculosis patients. The top three single drug resistance rate was SM,OFX,INH. The top 3 multiple drug resistance rate was INH ＋ RIF ＋SM ＋ OFX,INH ＋ SM,INH ＋ RIF ＋ SM. Conclusion The drug resistance of the Mycobacteria from recurrent pulmonary tuberculosis patients is serious,and recurrent pulmonary tuberculosis patients should be the focus of prevention and control,in order to prevent the occurrence of drug-resistant tuberculosis or even extensively drug-resistant tuberculosis.