2022-2023年茂名地区1077例结核分枝杆菌耐药情况及耐药影响因素

Drug Resistance and Influencing Factors of 1077 Cases of Mycobacterium Tuberculosis in Maoming Area from 2022 to 2023

目的:统计2022–2023年茂名地区1077例结核分枝杆菌耐药情况,并分析耐药影响因素。方法:以茂名地区2022–2023年结核分枝杆菌耐药性监测项目中三个县区采集的1077例痰液标本为研究对象,所有标本均经痰菌培养确定为结核分枝杆菌阳性,分析结核分枝杆菌耐药情况以及耐药的影响因素。结果:1077例标本中,2022–2023年期间的单药耐药率均较多耐药率、耐多药率高;且分别在2022年、2023年,单药耐药率也均较多耐药率、耐多药率高,差异均具有统计学意义(P<0.05);2022年耐药药物种类分布中,前4位分别为链霉素(SM)、异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB),均为一线抗结核药物;2023年耐药药物种类分布中,前6位分别为SM、INH、RFP及氧氟沙星(OFLX)、左氧氟沙星(LFX)及莫西沙星(MFX),包含3种一线抗结核药物及3种二线抗结核药物;2022–2023年总耐药药物种类分布中,前6位为分别为SM、INH、RFP、OFLX、LFX及MFX,包含3种一线抗结核药物及3种二线抗结核药物;复治患者的耐药发生率(19.23%)较未发生耐药患者(11.15%)高,差异具有统计学意义(P<0.05)。结论:2022–2023年茂名地区结核分枝杆菌的单药耐药率占比较多耐药率、耐多药率高,对SM、INH等药物的耐药性较高。复治为患者耐药影响因素。

Objective The drug resistance of 1077 cases of Mycobacterium tuberculosis in Maoming area from 2022 to 2023 was analyzed,and the influencing factors of drug resistance were analyzed.Methods A total of 1077 sputum samples collected from three counties of the Mycobacterium tuberculosis drug resistance monitoring project in Maoming from 2022 to 2023 were selected as the research object.All samples were confirmed to be positive for Mycobacterium tuberculosis by sputum culture.The drug resistance of Mycobacterium tuberculosis and the influencing factors of drug resistance were analyzed.Results In a cohort of 1077 sputum samples,the monotherapy resistance rate was higher than the polytherapy resistance rate and the multidrug-resistant rate during the period of 2022-2023.Similarly,in both 2022 and 2023,the monotherapy resistance rate was also higher than the polytherapy resistance rate and the multidrug-resistant rate,with statistically significant differences(P<0.05).In the distribution of drug resistance types in 2022,the top four drugs were Streptomycin(SM),Isoniazid(INH),Rifampicin(RFP),and Ethambutol(EMB),all of which are firstline anti-tuberculosis agents.In 2023,the top six drugs in the distribution of drug resistance types were SM,INH,RFP,and Ofloxacin(OFLX),Levofloxacin(LFX),and Moxifloxacin(MFX),including three first-line and three second-line anti-tuberculosis drugs.The overall distribution of drug resistance types from 2022 to 2023 indicated that the top six drugs were SM,INH,RFP,OFLX,LFX,and MFX,encompassing three first-line and three second-line anti-tuberculosis drugs.The incidence of drug resistance in retreatment patients(19.23%)was higher than that in non-drug-resistant patients(11.15%),and the difference was statistically significant(P<0.05).Conclusion The monotherapy resistance rate accounted for a higher proportion than the polytherapy resistance rate and the multidrug-resistant rate in Mycobacterium tuberculosis in the Maoming area from 2022 to 2023,with a higher resistance to drugs such as SM and INH.Retreatment is identified as a factor influencing patient drug resistance.