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目的了解临沂市2010年1月—12月结核病的耐药状况。方法我院2010年1月—12月所有前来就诊的痰结核菌培养阳性患者163例,痰培养阳性标本进行INH、RFP、SM、EMB、PAS、LVFX、PNA、C IP、ZMK、CPM 10种药物敏感试验。结果共有163株菌株进行了抗结核药耐药测定,结果66株有不同程度的耐药,总耐药率40%,耐多药21株(13%)。其中初始耐药27%,继发耐药58%,差异有统计学意义(2χ=15.17,P<0.01)。10种药物的耐药率由高到低依次为:RFP36.2%,SM23.2%,INH18.6%,C IP18.6%,AMK17.4%,CPM13.0%,PAS10.1%,LVFX10.1%,PNA10.1%,EMB2.9%。结论临沂市结核菌耐药情况处于较高水平,今后应根据特点加强防治措施。C IP,CPM,LVFX若作为抗结核药物应用,应加大剂量,以此来提高疗效和减少耐药菌产生。
Objective To understand the drug resistance of tuberculosis in January-December 2010 in Linyi City. Methods A total of 163 positive sputum TB patients from January to December 2010 in our hospital were enrolled in this study. Positive sputum culture samples were collected for INH, RFP, SM, EMB, PAS, LVFX, PNA, IPP, ZMK and CPM 10 Drug susceptibility testing. Results A total of 163 isolates were tested for anti-TB drug resistance. Results showed that 66 isolates were resistant to various degrees with a total drug resistance rate of 40% and multi-drug resistance rate of 21 (13%). Among them, the initial resistance was 27% and the secondary resistance was 58%, the difference was statistically significant (2χ = 15.17, P <0.01). The resistance rates of the 10 drugs were as follows: RFP36.2%, SM23.2%, INH18.6%, CIP18.6%, AMK17.4%, CPM13.0%, PAS10.1% LVFX10.1%, PNA10.1%, EMB2.9%. Conclusion The drug resistance of Mycobacterium tuberculosis in Linyi City is at a high level, and the prevention and cure measures should be strengthened according to the characteristics in the future. C IP, CPM, LVFX If used as anti-TB drugs, should increase the dose, in order to improve the efficacy and reduce drug-resistant bacteria.