耐药结核病的流行和监测现状

The prevalence and surveillance of drug-resistant tuberculosis

结核分枝杆菌的耐药性已成为全球关注的重大公共卫生挑战。根据世界卫生组织(World Health Organization,WHO)的统计,我国是全球22个结核病(tuberculosis,TB)高负担国家之一,也是全球27个耐多药结核病(multi-drug resistant TB,MDRTB)高负担国家之一。耐药结核病(drug resistant TB,DR-TB)是中国结核病防治工作的三大挑战之一,如若耐药结核病的流行不能得到有效控制,将会影响我国"2035年终止结核病流行目标"的顺利实现。结核病耐药性监测对于指导合理使用抗生素起着至关重要的作用,耐药监测是评估结核病防治规划实施效果的有效指标。1994年,WHO和国际防痨及肺部疾病联合会(International Union Against Tuberculosis and Lung Disease,UNION)共同开展了一项全球性的结核病耐药性监测项目,我国除参与该项目外,同时积极开展了多次全国结核病流行病学调查,并成功开展了全国结核病耐药性基线调查,为制定科学防治结核病的策略措施提供重要参考依据。

The drug resistance of Mycobacterium tuberculosis has become a major public health challenge of global concern. According to the statistics of the World Health Organization （WHO）, China is one of the 22 high-burden countries with tuberculosis （TB） in the world, and it is also one of the 27 high-burden countries with multidrug resistant TB （MDR-TB） patients worldwide. Drug-resistant tuberculosis （DR-TB） is one of the three major challenges in the prevention and treatment of tuberculosis in China. If the prevalence of drug-resistant tuberculosis cannot be effectively controlled, it will affect the smooth realization of the ＂end of TB epidemic in 2035＂ in China. The surveillance of drug resistance of tuberculosis plays an important role in guiding the rational use of antibiotics. Drug resistance monitoring is an effective indicator for assessing the effectiveness of tuberculosis prevention and control programs. In 1994, WHO and the International Union Against Tuberculosis and Lung Disease （UNION） jointly launched a global tuberculosis resistance surveillance project. In addition to participating in this project, China has conducted five national epidemiological investigations of tuberculosis and a national survey of drug-resistant tuberculosis, which provided an important reference for formulating scientific strategies for the prevention and treatment of tuberculosis.