邯郸市2016—2019年结核病耐药筛查结果分析

Analysis of on drug resistance screening results of tuberculosis in Handan from 2016 to 2019

目的分析研究邯郸市2016—2019年结核分枝杆菌(Mycobacterium tuberculosis,MTB)耐药筛查结果的规律与特征,为耐药结核病的规范治疗、结核病的防制提供参考依据。方法分析研究邯郸市2016—2019年辖区16个县(市、区)结核病定点医疗机构培养的所有病原学阳性患者分枝杆菌培养菌株,采用固体比例法对8种一、二线药物进行耐药筛查。结果邯郸市2016—2019年各年总体耐药率分别为23.7%、23.2%、29.8%、44.1%,差异有统计学意义(χ^(2)=30.19,P<0.01)。各年利福平耐药(Rifampin Resistant Tuberculosis,RR-TB)率分别为12.6%、10.2%、22.1%、24.5%,差异有统计学意义(χ^(2)=21.37,P<0.01);耐多药(Multi-drug resistant,MDR)率分别为9.3%、10.2%、11.9%、12.2%,差异有统计学意义(χ^(2)=1.35,P=0.7184)。各年非结核分枝杆菌(nontuberculous mycobacterium,NTM)发现率分别为3.7%、3.4%、2.6%、2.0%,差异有统计学意义(χ^(2)=1.42,P=0.7008)。结论邯郸市2016—2019年结核耐药情况整体呈上升态势,总体耐药率和利福平耐药率逐年增加。提示需早发现、早治疗患者,规范合理用药,指导临床正确的化疗方案,杜绝普通结核发展成耐药结核。

Objective To analyze and study the law and characteristics of drug-resistant Mycobacterium tuberculosis(MTB)screening results in Handan from 2016 to 2019,and to provide reference for standard treatment,prevention,management and epidemic control of tuberculosis in the future.Methods Cultured mycobacterial strains from 16 counties(cities and districts)in Handan City from 2016 to 2019 were analyzed and studied,the drug resistance of 8 kinds of first-line and second-line drugs were screened by solid proportion method.Results The overall drug resistance rate from 2016 to 2019 was 23.7%,23.2%,29.8%and 44.1%respectively,and the differences were statistically significant(χ^(2)=30.19,P<0.01).The rate of Rifampin Resistant Tuberculosis(RR-TB)during years were 12.6%,10.2%,22.1%and 24.5%respectively,and the differences were statistically significant(χ^(2)=21.37,P<0.01).Multi-drug resistant(MDR)during years were 9.3%,10.2%,11.9%and 12.2%,and the differences were statistically significant(χ^(2)=1.35,P=0.7184).The detection rate of nontuberculous mycobacterium(NTM)was 3.7%,3.4%,2.6%and 2.0%,and the and the differences were statistically significant(χ^(2)=1.42,P=0.7008).Conclusion The drug-resistant situation of tuberculosis in Handan is on the rise from 2016 to 2019,and the overall drug-resistance rate and the resistance rate of rifampin increase year by year.It is advised that patients should be found and treated early,standardized and rational medication should be implemented,correct clinical chemotherapy regimen should be guided,and the development from common tuberculosis into drug-resistant tuberculosis should be prevented.