佛山市15~24岁涂阳肺结核患者耐药情况分析

Drug resistance of Smear-positive Pulmonary Tuberculosis Patients Aged 15~24 in Foshan

【目的】分析本地区以学生为主的15~24岁人群涂阳肺结核患者的耐药情况。【方法】选择2017年1月至2018年6月佛山市结核病控制项目登记的250例涂阳肺结核患者的临床资料,对分离出的246株结核分枝杆菌(MTB)菌株采用WHO及国际结核和肺部疾病联合会推荐的比例法进行链霉素(SM)、异胭肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、氧氟沙星(OFX)、丁胺卡那(AM)、卷曲霉素(CM)、丙硫异烟胺(PTO)、对氨基水杨酸(PAS)等一、二线抗结核药物的药物敏感性实验。【结果】246株Mtb菌株中总耐药51株(20.73%)、单耐药34株(13.82%)、多耐药12株(4.88%)、耐多药4株(1.63%)、广泛耐药1株(0.41%)。男性总耐药率为19.61%(30/154)低于女性的22.58%(21/93),但差异无统计学意义(χ2=0.31,P>0.05)。地区总耐药率分别为三水区19.44%(7/36)、南海区18.18%(14/77)、禅城区24.53%(26/106)、高明区14.81%(4/27),各地区间差异无统计学意义(χ2=0.63,P>0.05)。【结论】佛山市15~24岁涂阳肺结核患者耐药流行趋势不容乐观,应加强关键环节的控制,减少耐药性。

【Objective】To analyze the drug resistance of Smear-positive tuberculosis patients aged 15~24 years in this area.【Methods】The clinical data of 250 smear-positive pulmonary tuberculosis patients registered in Foshan tuberculosis control project from January 2017 to June 2018 were selected. 246 strains of Mycobacterium tuberculosis (MTB) were isolated by using the proportions recommended by WHO and the International Federation of Tuberculosis and Pulmonary Diseases to determine drug susceptibility tests of first and second-line anti-tuberculosis such as streptomycin (SM), isoniazid (INH), rifampicin (RFP), ethambutol (EMB) and ofloxacin (OFX). amikacin (AM), capreomycin (CM), isonicotinamide propionate (PTO) and aminosalicylic acid (PAS).【Results】Among 246 strains of Mtb,there were 51 strains (20.73%) with total drug resistance, 34 strains (13.82%) with single drug resistance, 12 strains (4.88%) with multi-drug resistance, 4 strains (1.63%) with multi-drug resistance and 1 strain (0.41%) with extensive drug resistance. The total drug resistance rate of male was 19.61%(30/154), which was lower than that of female 22.58%(21/93), but there was no significant difference between male and female (χ2<0.31,P>0.05). The total drug resistance rates were 19.44%(7/36) in Sanshui District, 18.18%(14/77) in Nanhai District, 24.53%(26/106) in Chancheng District and 14.81%(4/27) in Gaoming District, respectively. There was no significant difference among regions (χ2 ≤ 0.63,P>0.05).【Conclusion】The epidemic trend of drug resistance among Smear positive pulmonary tuberculosis patients aged 15~24 in Foshan City is not optimistic. It is necessary to strengthen the control of key links and reduce drug resistance.