广州市海珠区肺结核病人的耐药性监测

Monitoring of initial drag resistant status in patients with puhnonary tuberculosis in Haizhu District of Guangzhou City

目的 监测肺结核菌阳性病人的起始耐药情况,评价抗痨效果和结核病控制现状。方法 按DOTS方案进行药敏试验,监测新发病例痰培养结核菌阳性的抗痨药物敏感性。结果1996～2001年每年起始耐药率在10.9％～30.4％范围内.平均起始耐药率为21.5％(105/489);70～岁组起始耐药率最低(10.5％),50～岁组起始耐药率最高(27.1％)。异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)的耐药率依次为:H>S>R=E,以H耐药率最高17.8％(87/489);而同时以H、R、E、S的4种药物耐药率仅为1.0％(5/489)。结论 临床抗痨药物耐药情况严重,建议使用抗结核复合剂,严格DOTS治疗,以降低结核病耐药并控制结核病。

Objective To investigate the initial drug-resistance in patients with pulmonary tuberculosis in Haizhu District and evaluate the effectiveness of tuberculosis control work in this district. Methods The detection of resistance to anti - tuberculosis drugs was carried out based on WHO recommended Dots treatment for monitoring the sensitivity of the tubercle bacillus form smear - positive samples to antibiotics. Results The initial resistant rate in 1996-2001 was in the rang of 10.9%-30.4%,average21.5%(105/ 489).The rate of initial resistance in the age group of 70- was lower( 10.5%) and it was higher in the age group of 50 ~ (27.1%). The drug resistance was in the order of hydrazide (H) > streptomycin(S) > rifampicin( R) = ethambutol(E), being 17.8 % to H, ( 87/ 489). It was observed that the resistance to four combined use of antibiotics of HRES was the lowest, being 1.0% (5/489) . Conclusion The resistance of tubercle bacillus to antibiotics is getting serious and compound anti - tuberculosis drug be developed to tackle the resistant problems in addition to standardize the treatment of WHO recommended DOTS in order to elongate the development of the resistance and control the disease.