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目的了解上海市流动人口的结核病耐药状况及相关因素,为制定流动人口的结核病控制策略提供依据。方法将上海市各区县结核病定点医院2004年2月至2005年1月诊治的流动人口中所有新发及复治的痰培养阳性肺结核病例作为研究对象,并对所有分离培养阳性菌株进行菌型鉴定及利福平、异烟肼、链霉素及乙胺丁醇敏感性测试,分析流动人口耐药结核病的流行状况及相关因素。结果共入选493例培养阳性肺结核患者,最后获得431例(占87.4%)患者的菌型鉴定及药敏结果,其中结核分枝杆菌427例(占99.1%),非结核分枝杆菌4例(占0.9%)。肺结核患者的总耐药率为18.3%(78/427),耐多药率为5.9%(25/427);新发患者的耐药率为16.0%(62/387),耐多药率为4.1%(16/387);复治患者的耐药率为40.0%(16/40),耐多药率为22.5%(9/40)。经单因素及多因素分析,45～60岁年龄组及复治病例是耐药及耐多药结核病的相关因素。结论上海市流动人口的结核病耐药率较高,今后要根据流动人口的特点加强防治措施。
Objective To understand the status of TB drug resistance in floating population in Shanghai and its related factors, and to provide basis for developing TB control strategy for floating population. Methods All cases of newly diagnosed sputum culture positive pulmonary tuberculosis in the floating population diagnosed and treated from February 2004 to January 2005 in TB district designated hospitals of Shanghai were selected as research objects and all the isolates And rifampicin, isoniazid, streptomycin and ethambutol sensitivity test to analyze the prevalence of drug-resistant TB in floating population and related factors. Results A total of 493 patients with positive pulmonary tuberculosis were enrolled. Finally, 431 patients (87.4%) were identified and susceptible to drug susceptibility. Among them, 427 were Mycobacterium tuberculosis (99.1%), 4 were non-tuberculous Mycobacterium Accounting for 0.9%). The total resistance rate of tuberculosis patients was 18.3% (78/427), and the rate of multidrug-resistant patients was 5.9% (25/427). The rate of new drug-resistant patients was 16.0% (62/387) 4.1% (16/387) respectively. The rate of drug resistance in retreatment patients was 40.0% (16/40) and the rate of multidrug resistance was 22.5% (9/40). After univariate and multivariate analysis, 45-60 age group and retreatment cases were the related factors of drug resistance and multidrug-resistant tuberculosis. Conclusion The TB population in Shanghai’s floating population has a high rate of TB drug abuse. In the future, prevention and control measures should be strengthened according to the characteristics of floating population.