2016-2020年北京市昌平区结核分枝杆菌耐药状况分析

Analysis of drug resistance status of Mycobacterium tuberculosis in selected areas of Beijing from 2016 to 2020

目的分析2016年-2020年近五年期间北京市昌平区就诊患者的耐药情况。方法对2016-2020年期间痰培养阳性患者分离株进行固体药物敏感性试验,并对这五年期间结核和非结核分枝杆菌构成比、相应药敏结果的抗结核药物耐药状况及耐药结核相关因素等指标进行系统分析。结果北京市昌平区2016-2020年五年间非结核分枝杆菌构成比无统计学意义(P>0.05)。在分析各年份不同药物组耐药状况中,在耐一种药物组中,异烟肼耐药构成比具有统计学差异(χ^(2)=10.261,P=0.036),利福平耐药构成比同样具有统计学差异(χ^(2)=10.520,P=0.033);在耐两种药物组中,异烟肼和利福平组(H+R)及异烟肼和链霉素组(H+S)具有统计学差异(χ^(2)=11.220,P=0.024;χ^(2)=13.369,P=0.010);在耐三种药物组中,异烟肼、利福平和链霉素组合(HRS)具有统计学差异(χ^(2)=9.823,P=0.041);其他药物及药物组合不具有统计学差异(P>0.05),此外,各年份间总的耐药构成比具有统计学差异(χ^(2)=15.165,P=0.004)。各年龄组之间结核患者的耐药情况不具有统计学差异(P>0.05)。在耐药结核病相关因素分析中,性别相关因素中,整体来看女性耐药构成比稍高于男性,年龄组相关因素中,各年份耐药构成比无统计学差异(P>0.05)。结论耐药结核病在该地区仍然是重要挑战,其中女性是耐药监测关注的重点,重点人群筛查、耐药监测应是当地结核病防控治疗中重要举措。

Objective To analyze the drug resistance of patients diagnosed in Beijing Changping during five years from 2016 to 2020.Methods Solid drug susceptibility tests were performed on sputum culture-positive patient isolates during the years 2016 to 2020,and indicators such as the composition ratio of tuberculosis and nontuberculous mycobacteria,the anti-tuberculosis drug resistance status of the corresponding drug sensitivity results,and factors associated with drug-resistant tuberculosis were systematically analyzed during the last five years.Results The composition ratio of nontuberculous mycobacteria in the five years from 2016 to 2020 in Beijing Changping was not statistically significant(P>0.05).In the analysis of the resistance status of different drug groups by year,the composition ratio of isoniazid resistance was statistically different in the group of resistance to one drug(χ^(2)=10.261,P=0.036),and the composition ratio of rifampicin resistance was also statistically different(χ^(2)=10.520,P=0.033).In the two drug-resistant groups,there was a statistical difference between the isoniazid and rifampicin group(H+R)and the isoniazid and streptomycin group(H+S)(χ^(2)=11.220,P=0.024;χ^(2)=13.369,P=0.010).In the three-drug-resistant group,the combination of isoniazid,rifampicin,and streptomycin(HRS)was statistically different(χ^(2)=9.823,P=0.041).Other drugs and drug combinations were not statistically different(P>0.05),in addition,the overall drug resistance composition ratio was statistically different between years(χ^(2)=15.165,P=0.004).Drug resistance in TB patients was not statistically different between age groups(P>0.05).In the analysis of factors associated with drug-resistant tuberculosis,among the gender-related factors,the drug-resistant composition ratio was slightly higher in women than in men overall,and among the age group-related factors,the drug-resistant composition ratio was not statistically different between age groups(P>0.05).Conclusion Drug-resistant TB remains an important challenge in the region,with women being the focus of drugresistant surveillance attention,and screening of key populations and drug-resistant surveillance should be important initiatives in local TB prevention and control treatment.