2018—2021年徐州市利福平耐药结核病流行特征分析

Analysis of epidemiological characteristics of rifampicin-resistant tuberculosis in Xuzhou City from 2018 to 2021

目的了解徐州市结核病患者流行病学特征以及服用利福平药物耐药情况,为开展耐药结核病防控工作提供参考。方法依据“中国疾病预防控制信息系统”的“监测报告管理”中“耐药病案管理”资料,采用描述性流行病学方法收集徐州市2018—2021年病原学阳性结核病患者年龄、性别、职业、登记分类等资料以及病原菌对利福平的耐药情况,采用单因素和多因素logistic回归分析利福平耐药影响因素。结果2018—2021年徐州市利福平耐药结核病患者190例,总利福平耐药率为3.45%。女性的利福平耐药率为3.11%,男性的利福平耐药率为3.57%,两者比较差异无统计学意义(χ^(2)=0.616,P>0.05);不同年龄组间差异均有统计学意义(χ^(2)=25.598,P<0.001):≤30岁组利福平耐药率为4.26%,>30~45岁组利福平耐药率最高,为5.37%,>45~60岁组利福平耐药率为4.05%,>60岁组利福平耐药率为2.05%;不同职业间差异有统计学意义(χ^(2)=18.738,P<0.05),农民利福平耐药率为2.94%,家政家务及待业利福平耐药率为5.33%,离退人员利福平耐药率为4.19%,学生利福平耐药率为3.27%,工人利福平耐药率最高,为7.75%,其他利福平耐药率为3.01%;复治患者利福平耐药率高于初治患者(χ^(2)=65.009,P<0.05);非农民利福平耐药率高于农民(χ^(2)=10.79,P<0.05)。多因素logistic回归分析发现:年龄、职业、治疗史均进入模型,复治患者发生利福平耐药的危险高于初治患者(OR值为3.885;P<0.001),非农民比农民更易发生利福平耐药(OR值为1.458;P<0.05),与年龄≤30岁组相比,45~60岁的患者更易发生利福平耐药(OR值为2.73;P<0.001)。结论中青年、非农民患者以及复治患者是利福平耐药防控的重点人群,应加强对此类患者的筛查及规范治疗工作。

Objective To investigate the epidemiological characteristics of tuberculosis(TB)patients and their rifampicin-resistant status in Xuzhou City,to provide references for the prevention and control of drug-resistant TB.Methods Based on the data of“Management of Drug Resistance Cases”in the“Management of Surveillance Reports”of the“Chinese Information System for Disease Control and Prevention”,the descriptive epidemiological method was used to collect the age,gender,occupation,registration,classification,and the resistance of pathogenic bacteria to rifampicin of pathogenic positive TB patients in Xuzhou City from 2018 to 2021,and the univariate and multivariate logistic regression analyses were used to analyze the influencing factors of rifampicin resistance.Results From 2018 to 2021,there were 190 rifampicin-resistant TB patients in Xuzhou City,and the total rifampicin-resistant rate was 3.45%.There was no significant difference between the rifampicin-resistant rates of women(3.11%)and men(3.57%)(χ^(2)=0.616,P>0.05).There were statistically significant differences among different age groups(χ^(2)=25.598,P<0.001).The≤30-year-old group had a 4.26%rifampicin-resistant rate,the>30-45-year-old group had the highest rifampicin-resistant rate of 5.37%,the>45-60-year-old group had a rifampicin-resistant rate of 4.05%,and the>60-year-old group had a rifampicin-resistant rate of 2.05%.There were statistically significant differences among different occupations(χ^(2)=18.738,P<0.05),the resistance rate of rifampicin in farmers was 2.94%,the resistance rate of rifampicin in housekeeping and unemployed was 5.33%,the resistance rate of rifampicin in retired personnel was 4.19%,the resistance rate of rifampicin among students was 3.27%,the resistance rate of rifampicin in workers was the highest(7.75%),and the resistance rate of rifampicin in other people was 3.01%.The resistance rate of rifampicin in retreated patients was higher than that in newly treated patients(χ^(2)=65.009,P<0.05),and the resistance rate of rifampicin in non-farmers was higher than that in farmers(χ^(2)=10.79,P<0.05).Multivariate logistic regression analysis showed that age,occupation,and treatment history were all included in the model,and the risk of rifampicin resistance in relapsed patients was higher than that in naive patients(OR=3.885,P<0.001),non-farmers were more likely to develop rifampicin resistance than farmers(OR=1.458;P<0.05).Compared with the age≤30-year-old group,patients aged 45-60 years were more likely to develop rifampicin resistance(OR=2.73,P<0.001).Conclusion Young and middle-aged patients,non-farmer patients,and retreated patients are the key groups for the prevention and control of rifampicin resistance,and the screening and standardized treatment of such patients should be strengthened.