2018—2020年浙江省金华地区肺结核耐药性分析

Drug resistance of tuberculosis in Jinhua Area,Zhejiang Province,from 2018 to 2020

目的 分析浙江省金华地区2018—2020年肺结核的耐药情况,以指导临床规范用药。方法 收集2018—2020年金华地区786例肺结核患者的病历资料,分析检出的结核杆菌对常用一线(异烟肼、利福平、链霉素、乙氨丁醇)和二线(卡那霉素、丙硫异烟胺、氧氟沙星、卷曲霉素、对氨基水杨酸)抗结核药物的耐药性。结果 检出的阳性菌株总耐药率(对1种及以上药物耐药)为20.99%(165/786)。其中,初治耐药率为13.54%(83/613),获得性耐药率为47.40%(82/173);耐多药率为10.56%(83/786),初治耐多药率为3.59%(22/613),复治耐多药率为35.26%(61/173)。786株结核杆菌对常用抗结核药物耐单药前3位为链霉素(13.23%)、异烟肼(12.85%)、利福平(9.03%),对丙硫异烟胺的耐药率最低(1.15%)。结论 2018—2020年,浙江省金华地区肺结核患者的总体耐药水平相对较低,但耐多药率仍然较高。

Objective To analyze the drug resistance situation of tuberculosis in Jinhua Area from 2018 to 2020,in order to guide the appropriate clinical use of drugs.Methods The medical records of 786 tuberculosis patients in Jinhua,Zhejiang Province from 2018 to 2020 were collected to analyze the drug resistance of Mycobacterium tuberculosis to commonly used first-line drugs(isoniazid,rifampicin,streptomycin,ethambutol) and second-line drugs(kanamycin,prothionamide,ofloxacin,cycloserine,para-aminosalicylic acid).Results The overall drug resistance rate(resistance to one or more drugs) of the detected positive strains was 20.99%(165/786).Among these strains,the drug resistance rate for initial treatment was 13.54%(83/613),and the acquired drug resistance rate was 47.40%(82/173).The rate of multidrug resistance was 10.56%(83/786),with an initial treatment multidrug resistance rate of 3.59%(22/613) and a retreatment multidrug resistance rate of 35.26%(61/173).The most commonly resistant drugs were streptomycin(13.23%),isoniazid(12.85%),and rifampicin(9.03%),while prothionamide had the lowest resistance rate(1.15%).Conclusions From 2018 to 2020,the overall drug resistance level among pulmonary tuberculosis patients in Jinhua Area,was relatively low.However,the rate of multidrug resistance remained high.