佛山市顺德区复治涂阳肺结核患者耐药情况及影响因素分析

Analysis of drug resistance and influencing factors of smear positive pulmonary tuberculosis patients in Shunde District,Foshan City

目的了解佛山市顺德区复治肺结核患者的耐药状况,为结核病防治对策制定提供依据。方法收集2015年1月—2019年12月佛山市顺德区复治涂阳肺结核患者,分离培养阳性的结核分枝杆菌174株进行药敏试验并分析结果。同时回顾性分析《广东省结核病耐药性监测患者信息表》的内容,分析患者耐药相关的危险因素。结果复治涂阳肺结核患者的总耐药率为48.85%,MDR率为16.09%,XDR-TB率为2.87%,结核药物耐药顺序为SM>INH>RFP>EMB>PAS>OFX>CPM>PTO>KM。患者的平均年龄为(50.76±16.02)岁,农民与家政、家务及待业人员为主要来源;非常住人口与常住人口的总耐药率差异有统计学意义(P<0.05)。结论初治失败和复发患者是MDR-TB的高危人群,老年人、农民与家政、家务及待业人员、非常住人员可能是佛山市顺德区复治患者耐药的主要因素。

Objective To understand the drug resistance of retreated pulmonary tuberculosis patients in Shunde District,and to provide basis for the formulation of tuberculosis prevention and control countermeasures.Methods From January 2015 to December 2019,174 strains of Mycobacterium tuberculosis were isolated and cultured from retreated smear positive pulmonary tuberculosis patients in Shunde District for drug sensitivity test and analysis of the results.At the same time,retrospective analysis was performed on the content of Guangdong Province TB Drug Resistance Monitoring Patient Information Table,and the risk factors related to drug resistance were analyzed.Results The total drug resistance rate was 48.85%,MDR rate was 16.09%,and XDR-TB rate was 2.87%.The order of drug resistance was SM>INH>RFP>EMB>PAS>OFX>CPM>PTO>KM.Through the content analysis of the information table:the average age of the patients was(50.76±16.02)years old,and the main sources were farmers,domestic workers,domestic workers and unemployed people.The total drug resistance rate of non-resident population and registered population was statistically significant(P<0.05).Conclusion The elderly,farmers and housekeepers,domestic workers and unemployed people,non-residents may be the main factors of drug resistance of retreated patients in Shunde District.