论文部分内容阅读
目的了解武汉市儿童结核病流行、耐药特点,为儿童结核病防治提供指导。方法将2013年1月-2015年12月武汉市医疗救治中心收治的458例痰涂片阳性儿童肺结核患儿纳入调查,对其分离菌株进行异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、吡嗪酰胺(PZA)、氧氟沙星(Ofx)、链霉素(S)、卡那霉素(Km)7种体外药敏实验,分析其耐药性和流行病学特点。结果药敏结果显示,药敏组328例(71.62%),耐药组130例(28.38%),其中单一耐药率11.14%,多耐药率5.90%,耐多药率7.42%,全耐药率3.93%,初治和复治分离菌在多耐药、耐多药、全耐药和总耐药方面差异有统计学意义(P<0.05);130例结核病耐药菌株总体耐药顺位为INH 35.38%,PZA 27.69%,S 26.15%,RFP 25.38%,Ofx13.85%,EMB 12.31%;药敏组与耐药组患儿在父母文化程度、父母职业、家庭收入、治疗史、户籍地、人口性质方面差异有统计学意义(P<0.05)。结论 2013-2015年武汉市儿童结核病耐药率处于较高水平,加强低文化、低收入、流动人群肺结核防治宣传力度,减少复治患儿和加强治疗完成率是预防肺结核耐药性的关键。
Objective To understand the prevalence and drug resistance of childhood tuberculosis in Wuhan and to provide guidance for the prevention and treatment of tuberculosis in children. Methods 458 sputum smear-positive children with tuberculosis from January 2013 to December 2015 in Wuhan Medical Treatment Center were enrolled in this study. INH, RFP, (EMB), pyrazinamide (PZA), ofxofloxacin (Ofx), streptomycin (S), kanamycin (Km) in vitro susceptibility testing, analysis of its resistance and Epidemiological characteristics. Results The results of susceptibility testing showed that 328 cases (71.62%) in susceptibility group and 130 cases (28.38%) in drug resistance group had single drug resistance rate of 11.14%, multi-drug resistance rate of 5.90%, multidrug resistance rate of 7.42% The drug-resistant rate was 3.93%. There was significant difference between multidrug-resistant, multidrug-resistant, all-drug-resistant and total drug-resistant isolates in newly diagnosed and retreatment patients (P <0.05) The drug sensitivity group and resistant group had significant differences in parents’ education level, parental occupation, family income, treatment history, family history, Domicile, the nature of the population difference was statistically significant (P <0.05). Conclusion The prevalence of TB among children in Wuhan during the period of 2013-2015 is at a high level. It is imperative to strengthen the awareness of tuberculosis prevention and treatment in low-culture, low-income and floating population, reduce the number of children with re-treatment and improve the completion rate of treatment.