论文部分内容阅读
目的了解廊坊市结核分枝杆菌耐药情况及结核病主要流行特征,为耐药结核病的防治提供科学依据。方法将廊坊市2009-2013年确诊登记的痰涂片阳性肺结核患者作为研究对象,对涂阳患者痰标本进行结核分枝杆菌分离培养和菌型鉴定,采用比例法对一线抗结核药物(异烟肼、利福平、乙胺丁醇、链霉素)和二线抗结核药物(卡那霉素、氧氟沙星)进行耐药性检测。结果结核分枝杆菌的总耐药率为46.4%(819/1 764),耐多药率为11.5%(203/1 764),广泛耐药率为1.1%(20/1 764);6种药物的耐药顺位依次是利福平、异烟肼、链霉素、乙胺丁醇、氧氟沙星、卡那霉素;复治患者的耐药率高于初治患者(χ2=18.2,P<0.05);流动人口的耐药率高于本地人口(χ2=14.3,P<0.05),差异均有统计学意义。结论廊坊市结核分枝杆菌的耐药率高于全国平均水平,复治患者和流动人口是结核病耐药高危人群,应根据特点采取有针对性的防治措施。
Objective To understand the prevalence of Mycobacterium tuberculosis and the prevalence of tuberculosis in Langfang and to provide a scientific basis for the prevention and treatment of drug-resistant tuberculosis. Methods The sputum smear-positive pulmonary tuberculosis patients diagnosed in 2009-2013 in Langfang City were selected as research objects. Mycobacterium tuberculosis was isolated and cultured in sputum from smear-positive patients. The proportion of first-line anti-tuberculosis drugs Hydrazine, rifampicin, ethambutol, streptomycin) and second-line anti-TB drugs (kanamycin, ofloxacin) for drug resistance testing. Results The total drug resistance rates of Mycobacterium tuberculosis were 46.4% (819/1 764), the multidrug resistance rate was 11.5% (203/1 764) and the rate of extensive drug resistance was 1.1% (20/1 764). Six Drug resistance sequence followed by rifampicin, isoniazid, streptomycin, ethambutol, ofloxacin, kanamycin; retreatment patients with drug resistance was higher than the initial treatment of patients (χ2 = 18.2, P <0.05). The resistance rate of floating population was higher than that of the local population (χ2 = 14.3, P <0.05), and the differences were statistically significant. Conclusion The drug resistance rate of Mycobacterium tuberculosis in Langfang City is higher than the national average level. The retreatment patients and floating population are at high risk of TB drug resistance. Specific prevention and control measures should be taken according to the characteristics.