2016—2020年济南市肺结核患者耐药情况分析

Drug-resistant tuberculosis among patients in Ji’nan from 2016 to 2020

目的:分析济南市肺结核患者的耐药情况,为耐药肺结核的防控提供依据。方法:采用回顾性的调查方法,对2016—2020年济南市1104例痰培养阳性肺结核患者的耐药检测结果进行分析。结果:2016—2020年济南市肺结核患者总耐药率为24.82%(274/1104),其中初治患者耐药率为21.47%(204/950),复治患者耐药率为45.45%(70/154);单耐药率为10.14%(112/1104),耐多药率为7.70%(85/1104),准广泛耐药率为1.54%(17/1104),其他耐药率为5.43%(60/1104)。2016—2020年肺结核患者总耐药率[2016年耐药率为50.00%(46/92),2017年耐药率为50.00%(32/64),2018年耐药率为24.44%(33/135),2019年耐药率为16.16%(58/359),2020年耐药率为23.13%(105/454)]呈下降趋势,差异有统计学意义(χ_(趋势)^(2)=38.100,P<0.001)。多因素logistic回归分析结果显示,以14~20岁年龄组为参照,21~40岁肺结核患者耐药率较高(OR=4.394,95%CI:1.325~14.570);以初治患者为参照,复治肺结核患者耐药率较高(OR=3.276,95%CI:2.264~4.740)。结论:济南市耐药肺结核疫情较为严重,应重点关注21~40岁与复治肺结核患者。

Objective:To analyze the drug resistance situation of pulmonary tuberculosis patients in Ji’nan,in order to provide basis for the prevention and control of drug-resistant pulmonary tuberculosis.Methods:The drug resistance results of 1104 patients with sputum culture positive pulmonary tuberculosis in Ji’nan from 2016 to 2020 were analyzed by retrospective research method.The factors affecting drug resistance of pulmonary tuberculosis patients were analyzed by univariate and multivariate logistic regression model.Results:From 2016 to 2020,the total drug resistance rate of pulmonary tuberculosis patients in Ji’nan was 24.82%(274/1104),of which the drug resistance rate of newly treated patients was 21.47%(204/950),and the drug resistance rate of retreated patients was 45.45%(70/154);The single drug resistance rate was 10.14%(112/1104),the multidrug-resistance rate was 7.70%(85/1104),the pre-extensively drug-resistant tuberculosis rate was 1.54%(17/1104),and the other drug resistance rate was 5.43%(60/1104).From 2016 to 2020,the total drug resistance rate of tuberculosis patients(the drug resistance rate was 50.00%(46/92)in 2016,and 50.00%(32/64)in 2017,24.44%(33/135)in 2018,16.16%(58/359)in 2019,and 23.13%(105/454)in 2020)showed a downward trend,and the difference was statistically significant(χ_(trend)^(2)=38.100,P<0.001).Multivariate logistic regression analysis showed that the drug resistance rate of pulmonary tuberculosis patients aged 21-40 was higher(OR=4.394,95%CI:1.325-14.570);The drug resistance rate of retreated pulmonary tuberculosis patients was higher(OR=3.276,95%CI:2.264-4.740).Conclusion:The epidemic situation of drug-resistant pulmonary tuberculosis in Ji’nan is serious.We should focus on patients aged 21-40 and retreated pulmonary tuberculosis patients.