2011—2020年北京市怀柔区耐药结核病高危人群利福平耐药筛查情况分析

Analysis of Rifampicin Resistance Screening Among High-risk Groups for Drug-resistant Tuberculosis in Huairou District of Beijing from 2011 to 2020

目的:通过筛查耐药结核病高危人群,了解北京市怀柔区耐药结核病高危人群利福平耐药情况。方法:统计2011—2020年登记管理的肺结核患者中耐药结核病高危人群筛查情况,包括筛查对象、结核菌培养及药敏试验,对耐药高危人群利福平耐药情况进行分析。结果:2011—2020年北京市怀柔区共登记利福平耐药高危人群130例,完成耐药筛查130例,筛查率为100.00%。实验室污染率为3.08%,其中,涂阳培阴率为34.62%,主要体现在治疗2个月及以上的痰涂片或培养仍为阳性的初治患者中;耐药结核病高危人群培养阳性81例,菌种鉴定为结核分枝杆菌75例,检出利福平耐药23例,检出率为30.67%,明显高于与同期初治培养阳性的肺结核患者利福平耐药检率的3.33%,差异有统计学意义(χ^(2)=40.82,P<0.05)。结论:北京市怀柔区积极开展监测,使利福平耐药结核病能够得到有效的管理和医治,做到早发现、早治疗,避免因贫致病、因病返贫,更重要的是能够有效遏制利福平耐药肺结核的传播风险,减少对人们健康的危害。

Objective:To understand the rifampicin resistance status of drug-resistant tuberculosis high-risk population in Huairou District of Beijing by screening drug-resistant tuberculosis high-risk population.Methods:Screening of drug-resistant tuberculosis high-risk groups among tuberculosis patients registered for management from 2011 to 2020 was enumerated,including screening subjects,tuberculosis culture and drug sensitivity tests,and rifampicin resistance was analyzed in drug-resistant high-risk groups.Results:From 2011 to 2020,a total of 130 cases of rifampicin-resistant high-risk groups were registered in Huairou District,Beijing,and 130 cases of resistance screening were completed,with a screening rate of 100.00%.The rate of laboratory contamination was 3.08%,with a smear-penetration rate of 34.62%,mainly in first-treatment patients whose sputum smears or cultures remained positive after 2 months of treatment or more.There were 81 cases of culture-positive drug-resistant tuberculosis in the high-risk group,with mycobacteria identified as Mycobacterium tuberculosis in 75 cases,and rifampicin resistance was detected in 23 cases,with a detection rate of 30.67%,which was significantly higher than 3.33%of the rifampicin-resistant detection rate in the initially culture-positive TB patients in the same period of time,and the difference was statistically significant(χ^(2)=40.82,P<0.05).Conclusion:Huairou District,Beijing,has been actively carrying out surveillance so that rifampicin-resistant tuberculosis can be effectively managed and treated,with early detection and treatment,avoiding poverty and returning to poverty,and more importantly,effectively curbing the risk of the spread of rifampicin-resistant tuberculosis,and minimizing the hazards to people’s health.