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目的了解泰州市当前肺结核耐药水平和流行趋势,为提高耐药结核病防治质量提供科学依据。方法对2012-2014年结核病信息管理系统中登记的全市痰培养阳性肺结核患者,采用比例法进行异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)、氧氟沙星(OFX)和卡那霉素(Km)的药敏试验结果进行分析。结果 1 239例痰培养阳性肺结核患者,总耐药率为9.20%,其中初治患者耐药率5.10%,复治患者耐药率20.18%;总耐多药率为5.65%,其中初治患者耐多药率2.33%,复治患者耐多药率14.54%;广泛耐药率为0.81%。6种抗结核药物的单耐药率顺位由高到低依次为:H(7.51%)、R(6.30%)、S(3.79%)、OFX(2.66%)、E(1.78%)、Km(1.61%)。复治患者耐药率、耐多药率、不同耐药种类数的耐药率均显著高于初治组,差异有统计学意义(P<0.001)。结论泰州市肺结核患者的耐药率较实施全球基金耐多药项目之前下降明显,基本与近年来国家调查结果及其他城市报道的数据一致,要针对本地区耐药状况,多措并举,进一步降低结核病耐药水平。
Objective To understand the current level of tuberculosis drug resistance and epidemiological trend in Taizhou and provide a scientific basis for improving the quality of drug-resistant tuberculosis. Methods 2012--2014 Tuberculosis registered in the information management system city tuberculosis patients sputum culture, for isoniazid (H), rifampin (R), streptomycin (S), using the ratio method ethambutol ( E), ofloxacin (OFX) and kanamycin (Km) were analyzed. Results 1239 sputum culture positive TB patients, the total resistance rate was 9.20%, wherein the rate of drug naive patients 5.10%, the rate of drug patients retreated 20.18%; total yield 5.65% MDR, wherein untreated patients MDR was 2.33%, MDR was 14.54%, and the rate of extensive drug resistance was 0.81%. The order of single drug resistance of 6 kinds of anti-tuberculosis drugs was H (7.51%), R (6.30%), S (3.79%), OFX (2.66%), E (1.61%). The rates of drug resistance, multidrug resistance and drug resistance in retreatment patients were significantly higher than those in the newly diagnosed patients, the difference was statistically significant (P <0.001). Conclusion The resistance rate of patients with pulmonary tuberculosis in Taizhou City dropped significantly compared with that before the implementation of Global Fund MDR Program, basically in line with the national survey results and the data reported by other cities in recent years. In response to the drug resistance in this area, the rate of resistance should be further reduced Tuberculosis drug resistance.