2011—2020年广东省佛山市利福平耐药结核病流行特征分析

Analysis of epidemiological characteristics of rifampicin resistance tuberculosis in Foshan City,Guangdong Province,2011-2020

目的:通过结核病常规监测数据分析佛山市利福平耐药结核病流行特征,为制定利福平耐药结核病防控策略提供参考依据。方法:对佛山市2011—2020年《结核病信息管理系统》中登记的普通肺结核患者、耐药可疑者和耐药患者病案进行清洗和整合,建立耐药结核病特征分析综合数据库。通过对各年份不同来源病原学阳性肺结核患者的耐药筛查情况、菌型鉴定结果和耐药检出情况进行分析,比较不同年份的变化趋势。结果:佛山市2011—2020年登记病原学阳性肺结核患者中,病原学阳性率由2011年34.0%(1629/4788)增加至2020年56.7%(1505/2655),年均递增率为5.8%。耐药筛查率总体呈现逐年上升的趋势,至2020年本年登记病原学阳性患者耐药筛查率达到100.0%(1505/1505)。2011—2020年期间本年登记初治患者、复治患者和往年登记患者利福平耐药率分别为1.9%(95%CI:1.7%~2.1%)、18.9%(95%CI:17.6%~20.3%)和24.4%(95%CI:23.1%~25.8%);本年登记初治患者利福平耐药率一直维持在比较低的水平,复治患者利福平耐药率由2019年的14.6%(13/89)下降到2020年的2.9%(2/69)。结论:佛山市常规结核病监测数据能够反映本市的利福平耐药结核病疫情现状,往年登记肺结核患者是下一步耐药结核病防控的重点。

Objective:To analyze the epidemiological characteristics of rifampicin drug-resistant tuberculosis in Foshan City through the routine surveillance data,and then provide a reference for formulating control and prevention strategies.Methods:The medical records of general tuberculosis patients,suspected drug-resistant and drug-resistant patients in the Tuberculosis Information Management System of Foshan City from 2011 to 2020 were cleaned and compiled to establish a comprehensive database.Drug resistance screening,pathogen identification and drug resistance detection were analyzed in different years from different sources,and the trend of resistance in different years was compared.Results:Among the registered pathogenic positive pulmonary tuberculosis patients in Foshan from 2011 to 2020,the pathogenic positive rate increased from 34.0%(1629/4788)in 2011 to 56.7%(1505/2655)in 2020,with an average annual increase rate of 5.8%.The overall drug resistance screening rate shows an upward trend year by year.By 2020,the drug resistance screening rate of registered pathogenic positive patients had reached 100.0%(1505/1505).From 2011 to 2020,the rifampicin resistance rates of newly treated patients,retreated patients and patients registered in previous years were 1.9%(95%CI:1.7%-2.1%),18.9%(95%CI:17.6%-20.3%)and 24.4%(95%CI:23.1%-25.8%)respectively.The rifampicin resistance rate of newly treated patients registered in the current year had been maintained at a relatively low level,and the rifampicin resistance rate of retreated patients had decreased from 14.6%(13/89)in 2019 to 2.9%(2/69)in 2020.Conclusion:Routine tuberculosis surveillance data can reflect the epidemic situation of rifampin resistant tuberculosis in Foshan city.The registration of tuberculosis patients in previous years is the focus of the next step in the prevention and control of drug-resistant tuberculosis.