论文部分内容阅读
目的:分析上海市松江区耐药结核分枝杆菌的流行变化趋势。方法:回顾性分析上海市松江区2014年1月至2018年12月培养阳性的1 105株结核分枝杆菌复合群，进行菌种鉴定(PNB法、TCH法和28℃培养试验)和药敏试验(四种一线抗结核药)，分析其耐药情况。结果:1 105株结核分枝杆菌中，总耐药率为18.8%(208/1 105)，其中初治患者的耐药率为17.9%(189/1 058)，复治患者的耐药率为40.4%(19/47)；总耐多药率4.0%(44/1 105)，其中初治患者的耐多药率为3.4%(36/1 058)，复治患者的耐多药率为17.0%(8/47)。5年总耐药率、初治患者耐药率、复治患者耐药率、总耐多药率、初治患者耐多药率、复治患者耐多药率均无上升趋势(χn 2趋势值分别为4.229、3.871、6.862、2.764、4.930、1.955，均n P>0.05)。五年耐多药率分别为2.6%、3.5%、4.4%、4.5%、5.4%，逐年递增。logistic回归分析显示，男性、老年群体、复治患者是上海市松江区结核病高发的因素，且复治患者更易产生耐药(n OR＝0.321，95%n CI：0.175～0.586，n P<0.01)和耐多药(n OR＝0.172，95%n CI：0.075～0.394，n P0.05). In the past five years, the multi-drug resistance rates were 2.6%, 3.5%, 4.4%, 4.5%, and 5.4%, respectively, increased year by year.Logistic regression analysis showed that males, elderly people, retreated patients and floating population were the main factors of tuberculosis in our district, and patients with retreatment were more likely to develop drug resistance (n OR=0.321, 95%n CI: 0.175-0.586, n P<0.01) and multidrug-resistant (n OR=0.172, 95%n CI: 0.075-0.394, n P<0.01).n Conclusion:In the past five years, the prevalence of M. tuberculosis in Songjiang District of Shanghai has been relatively stable, and the rate of multidrug resistance has increased year by year.