上海市奉贤区结核杆菌耐药性分析

Analysis on drug resistance of mycobacterium tuberculosis in Fengxian district Shanghai

[目的 ] 了解初治和复治肺结核病人对抗结核化学药物的敏感性。 [方法 ] 收集 2 0 0 2年 1月至 2 0 0 3年7月痰菌阳性标本 ,用改良罗氏培养基绝对浓度法试验 ,最终获取培养阳性标本 2 14份 ,对全部培养阳性标本进行 5种抗结核药物 (SM、INH、PAS、EMB、RFP)的耐药性测定。 [结果 ] 总耐药率为 3 9.2 5 % ( 84/2 14 ) ;初始耐药率为 11.83 %( 11/93 ) ,初始耐多药率为 7.5 3 % ( 7/93 ) ;获得性耐药率为 60 .3 3 % ( 73 /12 1) ,耐多药率为 47.93 % ( 5 8/12 1)。对抗结核药物的耐受 ,主要是耐受SM ( 75 .0 0 % ,63 /84)和INH( 63 .10 % ,5 3 /84)。 [结论 ] 获得性耐药率高于初始耐药率 ,应进一步加强对结核杆菌药物敏感性监测。

To understand primary and acquired drug resistance of mycobacterium tuberculosis. M.tuberculosis positive sputum samples were collected from January 2002 to July 2003. Ameliorative Lowenstein-Jensen' culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis. 214 samples were affirmed. Drug susceptibility test against streptomycin(SM), isoniazid (INH),rifampicin (RFP), ethambutol (EMB) and sodium para-aminosalicylate (PAS) were tested. The total drug resistance rate was 39.25% (84/214), the initial drug resistance rate was 11.83% (11/93), the initial multi-drug resistance rate was 7.53% (7/93), the acquired and multi-drug resistance(MDR) rate were 60.33% (73/121) .MDR-TB rate was 49.93% (58/121). SM and INH were primary and secondary resistance drugs, the rates were 75.00% (63/84) and 63.10% (53/84). [Conclusion] The acquired drug resistant and multi-drug resistant rates were higher than the initial drug resistance rate. Drug sensitivity surveillance on mycobacteria tuberculous should be further strengthened.