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目的了解衢州地区分枝杆菌菌种和药敏情况,为结核病的治疗与控制提供科学依据。方法对2013年-2016年衢州市分枝杆菌菌株进行耐药性检测和菌种初步鉴定。初筛为非结核分枝杆菌(NTM)的菌株利用基因芯片技术作菌种鉴定。结果 2 487株分枝杆菌经过鉴定,159株为NTM,2 328株为结核分枝杆菌。NTM的检出率从2013年的4.84%上升到2016年的8.25%。2 328株结核分枝杆菌的总耐药率为21.43%,耐多药率为5.71%,广泛耐药率为0.52%;复治患者的总耐药率、耐多药率、广泛耐药率以及对任一药物的耐药率均明显高于初治患者;单一耐药位于前3位分别为SM、OFX、INH,多耐药顺位的前3位为INH+RIF+SM+OFX、INH+SM、INH+RIF+SM。结论衢州地区复治结核患者耐药严重,应该将复治患者作为防控的重点,预防耐药结核甚至广泛耐药结核的发生。
Objective To understand the mycobacterial species and drug susceptibility in Quzhou area and provide a scientific basis for the treatment and control of tuberculosis. Methods The mycobacterial strains of Quzhou from 2013 to 2016 were tested for drug resistance and preliminary identification of strains. Strains that were initially screened for non-tuberculous mycobacteria (NTM) were genotyped using gene chip technology. Results 2 487 mycobacteria were identified, 159 were NTM and 2 328 were Mycobacterium tuberculosis. The detection rate of NTM increased from 4.84% in 2013 to 8.25% in 2016. The total drug resistance of 2 328 Mycobacterium tuberculosis strains was 21.43%, the multi-drug resistance rate was 5.71% and the broad-spectrum drug resistance rate was 0.52%. The total drug resistance rate, multi-drug resistance rate and multi-drug resistance rate And the drug resistance rate of any drug was significantly higher than that of the newly diagnosed patients. The top 3 single drug resistance was SM, OFX, INH, INH + RIF + SM + OFX, INH + SM, INH + RIF + SM. Conclusions The patients with retreatment tuberculosis in Quzhou are seriously drug-resistant. Therefore, patients with retreatment should be the focus of prevention and control to prevent the occurrence of drug-resistant tuberculosis or even extensive drug-resistant tuberculosis.