宾县2014—2016年肺结核患者耐药性监测分析

Analysis of drug resistance surveillance in Tuberculosis patients in Binxian,2014-2016

目的分析2014-2016年宾县结核病患者的耐药情况,为制定耐药结核病防治策略提供数据支持。方法对2014年1月-2016年12月全国结核病网络专报系统登记报告的宾县620例耐药肺结核患者,进行结核分枝杆菌培养和菌群鉴定。采用比例法药物敏感性试验(简称药敏试验),分析对一线与二线抗结核药物的耐药率及耐药谱情况。结果 2014-2016年宾县共发现620例耐药肺结核患者,其中148例鉴定为结核分枝杆菌感染,且共有46株被判断为耐药株;总耐药率为31.08%,其中单耐药率为73.91%,多耐药率为17.39%,耐多药率为8.70%。耐药患者以男性、农民、40~60岁、小学学历、年收入为5 000~10 000元的新患者为主。对4种抗结核药物中任意1种的耐药率由高到低的排序是S>R>H=OFX;共发现12种耐药谱,其中单耐药以耐S为主(45.65%),多耐药以耐H+S为主(8.70%),耐多药以耐H+R为主(4.35%)。结论对2014-2016宾县耐药肺结核患者的分析显示,中年人、男性、农民、学历为小学初中、收入不超过10 000元的新患者是防控工作重点人群及主要耐药人群。

Objectives To analyze the drug resistance of TB patients in Binxian from 2014 to 2016,provide data support for the development of drug resistance of TB control strategies.Methods Six hundred twenty patients with high-risk drug-resistant tuberculosis from Binxian which registered in national tuberculosis network report system from January 2014 to December 2016 were conducted the cultivation of Mycobacterium tuberculosis and the identification of flora.The proportional drug sensitivity test(referred to as "drug sensitivity test") was used to analyze the resistance rate and drug resistance spectrum of first-line and second-line anti-tuberculosis drugs.Results A total of 620 patients with high-risk drug-resistant tuberculosis were reported in Binxian from 2014 to 2016,of which 148 were identified as mycobacterium tuberculosis infection and their drug susceptibility test results were obtained.A total of 46 among 148 strains of mycobacterium tuberculosis were identified as resistant strains,the overall drug-resistant rate was (31.08%),and among which 73.91% of single drug resistant rate,17.39% of multiple drug-resistant rate,and 8.70% of multidrug-resistant rate.Most of the patients were male,famers,and the age of between 40 and 60,primary education,income 5000~10000 and newly diagnosed patients.The resistance rates of the four kinds of anti-tuberculosis drugs ranked as S>R>H=OFX total of 12 drug resistance spectrums were found.Among them,single resistance was mainly concentrated in S(45.65%),multiple resistance was mainly concentrated in H+S(8.70%),and multidrug resistance was mainly concentrated in H+R(4.35%).Conclusion The statistics of tuberculosis patients in Binxian from 2014 to 2016 showed that the middle-aged,male,farmers,primary education,income below 10,000 and the newly diagnosed patients are the key groups and the main drug-resistant population in the future prevention and control work.