北京市2019年流动人口肺结核流行特征及耐药情况分析

Analysis of tuberculosis epidemiological characteristics and drug resistance among the floating population in Beijing in 2019

目的分析北京市流动人口肺结核流行特征及耐药情况,为制定流动人口结核病防控策略提供科学依据。方法收集北京市2019年16个区级及1个市级结核病防治机构结核分枝杆菌培养阳性的肺结核患者资料,菌株样本采用比例法进行药物敏感性试验。患者按户籍所在地分为流动人口和北京市户籍。应用SPSS 19.0软件分析流动人口肺结核患者的流行特征及耐药情况。结果北京市2019年共有培养阳性肺结核患者1171例,其中流动人口患者593例(50.64%),男女性别比为2.2∶1(409∶184),相比于北京市户籍患者,流动人口患者的20~39岁青壮年(65.09%,386/593)、报告地区为城区(55.65%,330/593)和初治的比例(96.80%,574/593)较高,差异有统计学意义(均P<0.05)。在流动人口患者中,耐多药结核病占6.24%(37/593)。在复治的流动人口患者中,异烟肼耐药的比例(42.11%,8/19)和耐多药的比例(21.05%,4/19)明显高于初治患者(11.67%,67/574和5.75%,33/574),差异有统计学意义(均P<0.05)。结论2019年北京市流动人口肺结核患者以20~39岁青壮年男性、报告地区为城区和初治患者为主,流动人口中复治患者更容易出现耐多药和耐药问题,应作为防控的重点人群。

Objective To analyze the epidemic characteristics and drug resistance of pulmonary tuberculosis among the floating population in Beijing and to provide a scientific basis for formulating strategies for the prevention and control of tuberculosis among the floating population.Methods Data of tuberculosis patients who were positive for Mycobacterium tuberculosis culture was collected from 16 districts and one municipal institution of tuberculosis control and prevention in Beijing in 2019.The strain samples were tested for drug sensitivity by the proportional method.According to household registration location,patients were divided into the floating population and Beijing registration.SPSS 19.0 software analyzed tuberculosis patients'epidemic characteristics and drug resistance in the floating population.Results In 2019,there were 1171 culture-positive tuberculosis patients in Beijing,among the floating population,593(50.64%)patients were identified,with a male-to-female sex ratio of 2.2∶1(409∶184).Compared to patients under household registration as Beijing residents,a higher proportion of young adults aged 20-39 years(65.09%,386/593)were noticed,with 55.65%(330/593)reported from the urban areas and 96.80%(574/593)were reported the first time.The differences were statistically significant(all P<0.05).After completing the drug sensitivity test,37 cases were with multiple drug-resistant tuberculosis,accounting for 6.24%(37/593).The rates of isoniazid resistance(42.11%,8/19)and multidrug resistance(21.05%,4/19)in floating population patients after retreatment were significantly higher than those in newly treated patients(11.67%,67/574 and 5.75%,33/574),and the differences were statistically significant(all P<0.05).Conclusions Most patients with tuberculosis in the floating population in Beijing in 2019 were young males aged 20-39 years.The reporting areas were urban areas and the newly treated patients mainly.The patients with tuberculosis in the re-treated floating population were more likely to suffer from multidrug and drug resistance,which should be taken as the key population for prevention and control.