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目的了解贵州省结核病耐药状况,为制定全省结核病控制策略提供依据。方法 2012-2015年,在监测县收集结核菌株,用比例法进行6种抗结核药物对异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)、氧氟沙星(Ofx)、卡那霉素(Km)的药物敏感性测定。结果 2 169例患者中总耐药率为17.69%(466/2 169),耐多药率为5.50%(145/2 169),广泛耐药率为0.42%(11/2 169)。其中初始耐药率为15.24%(325/2 132),初始耐多药率为4.03%(86/2 132),获得性耐药率为28.03%(141/503),获得性耐多药率为11.73%(59/503)。获得性耐药率高于初始耐药率,差异有统计学意义(=45.718,P<0.05),获得性耐多药率高于初始耐多药率,差异有统计学意义(=46.353,P<0.05)。发现耐药谱25种,包括单耐药6种、多耐药12种、耐多药4种、广泛耐药3种。结论贵州省结核病耐药水平较低,但耐药谱呈现多样性和复杂性,应进一步加强耐药结核病的监测与防控。
Objective To understand the drug resistance status of TB in Guizhou Province and provide basis for the development of TB control strategy in the province. Methods From 2012 to 2015, tuberculosis strains were collected in the monitoring counties. Six anti-tuberculosis drugs were tested on isoniazid (H), rifampin (R), streptomycin (S), ethambutol (E) ), Ofxofloxacin (Ofx), kanamycin (Km) drug sensitivity assay. Results The total drug resistance rate in 2 169 patients was 17.69% (466/2 169), the multidrug resistance rate was 5.50% (145/2169) and the extensive drug resistance rate was 0.42% (11/2 169). The initial drug resistance rate was 15.24% (325/2 132), the initial multi-drug resistance rate was 4.03% (86/2 132), and the acquired drug resistance rate was 28.03% (141/503). The acquired multidrug resistance rate 11.73% (59/503). The acquired resistance rate was higher than the initial resistance rate, the difference was statistically significant (= 45.718, P <0.05), acquired multidrug resistance rate was higher than the initial multidrug resistance rate, the difference was statistically significant (= 46.353, P <0.05). 25 kinds of resistance spectrum were found, including 6 kinds of single drug resistance, 12 kinds of multidrug resistance, 4 kinds of multidrug resistance and 3 kinds of multidrug resistance. Conclusion The level of drug-resistant tuberculosis in Guizhou Province is low, but the spectrum of drug resistance is diverse and complex. Therefore, the surveillance and prevention and control of drug-resistant TB should be further strengthened.