重庆口岸出国移民肺结核监测分析

Analysis of pulmonary tuberculosis surveillance of immigration applicants at Chongqing port

目的掌握重庆口岸出国移民人员活动性肺结核流行现状。方法选取2014—2018年重庆市健康之友国际诊所赴英国及澳大利亚移民体检者中X线胸片异常者,对痰涂片镜检、痰培养及药敏试验结果进行回顾性分析。结果共筛查出176名胸片异常者,男性48.9%,女性51.1%。176名患者涂片镜检均未发现抗酸杆菌,有38例MGIT 960培养阳性,阳性率为21.6%,其中20例为肺结核,18例为非结核分枝杆菌感染;男性较多,主要集中于30岁以下和60岁以上。14例完成药敏检测的病例中,有7例为耐药结核,其中4例为耐多药结核;5种抗结核药物中,利福平的耐药率最高,最低为乙胺丁醇。结论重庆口岸出国移民中菌阳活动性肺结核以涂阴培阳患者为主,耐药率高。今后应加强对胸片异常者的结核分枝杆菌培养。

Objective To understand the prevalence of active pulmonary tuberculosis(PTB)among immigrate applicants in Chongqing port.Methods The cases of immigrants to Britain and Australia with abnormal chest X-ray screening in Chongqing Healthmate International Clinic from 2014 to 2018 were selected as subjects.The results of sputum smear,sputum culture and drug-susceptibility test of these cases were analyzed.Results A total of 176 cases with abnormal chest X-ray were screened.Among them,the males accounted for 48.9%and the females accounted for 51.1%.No smear-positive case was found.There were 38 cases showed cultured positive with MGIT960,the positive rate was 21.6%.Among the 38 cases,20 cases were identified as PTB and 18 cases were identified as non-tuberculosis mycobacterium.The male cases were more than those of the females among the PTB pa-tients,most of the cases were below 30 years or above 60 years old.The drug-susceptibility test was conducted in14 cases,7 of them were drug-resistant tuberculosis and 4 were multidrug-resistant tuberculosis.Among the 5 antituberculosis drugs,rifampicin had the highest drug-resistant rate,and the lowest one was ethambutol.Conclusion The sputum-positive active PTB patients in Chongqing port were mostly smear-negative and culture-positive,with higher drug resistance rate.In the future,we should to strengthen the Mycobacterium tuberculosis culture for the persons with abnormal chest X-ray.