论文部分内容阅读
目的初步了解浙江省宁波地区初治肺结核病例耐药情况,对现行结核病控制策略效果进行评价。方法按照世界卫生组织《结核病耐药监测指南》(WHO/IUATLD)的要求对初治病例痰培养阳性菌株进行异烟肼、利福平、链霉素和乙胺丁醇4种抗结核药物的敏感性测定及菌群鉴定。结果研究共纳入结核分枝杆菌974株,初治患者总耐药率为29.8%,耐多药率为5.0%。初治耐药病例中,18.5%仅对1种药物耐药,4种药物的耐药率顺位由高到低依次为链霉素(18.5%)、异烟肼(16.7%)、利福平(6.7%)、乙胺丁醇(5.2%)。与1999年耐药监测初治患者总耐药率17.8%相比,宁波市初治患者总耐药率上升差异有统计学意义(χ2=13.463,P<0.005),耐多药率水平也呈现升高趋势,结核分枝杆菌耐药性发生更趋向于单一耐药。结论宁波地区结核病耐药形势依然严峻,需进一步加强结核病防治工作。
Objective To understand the drug resistance of newly diagnosed pulmonary tuberculosis cases in Ningbo, Zhejiang Province and to evaluate the effectiveness of the current TB control strategies. Methods According to the WHO Guidelines for Monitoring Tuberculosis Drug Resistance (WHO / IUATLD), 4 positive samples of sputum culture positive for isoniazid, rifampicin, streptomycin and ethambutol Sensitivity and flora identification. Results A total of 974 strains of Mycobacterium tuberculosis were included in the study. The total drug resistance rate in initial treatment was 29.8% and the multidrug resistance rate was 5.0%. Among newly diagnosed drug-resistant cases, 18.5% were resistant to only one drug, and the order of resistance of the four drugs was streptomycin (18.5%), isoniazid (16.7%), Flat (6.7%), Ethambutol (5.2%). Compared with the 17.8% of the total drug resistance rate of the newly diagnosed patients in 1999, the total drug resistance rate in the newly diagnosed patients in Ningbo was significantly different (χ2 = 13.463, P <0.005), and the multidrug resistance rate also showed Increasing trend, the emergence of drug-resistant Mycobacterium tuberculosis tends to be more single-drug resistance. Conclusion The situation of TB drug resistance in Ningbo is still grim, and TB control should be further strengthened.