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目的研究楚雄州肺结核患者痰标本中结核分枝杆菌的耐药情况和变化规律,为制定结核病防治方案提供技术依据。方法收集2011年-2015年楚雄州辖区10县(市)疾控机构从肺结核患者痰标本中培养出的分枝杆菌,对其进行菌型鉴定及抗结核药物敏感性试验。结果收集并经鉴定为分枝杆菌的菌株共839株,其中人型占92.85%,牛型占2.14%,NTM占5.01%;各药物耐药率:INH为11.80%,RFP为7.51%,SM为12.28%,EMB为4.05%,KN为5.36%,OFX为5.36%;不同耐药类型耐药率:总体耐药率为23.72%,单耐药率为12.63%,耐多药率(MDR-TB)为5.24%,多耐药率为5.84%,广泛耐药率(XDR-TB)为1.19%,耐二线药率为1.67%。结论楚雄州引起肺结核病变的分枝杆菌主要以人型为主,NTM虽然所占比例较小,但耐药率较高;楚雄州广泛耐药率(XDR-TB)高于全国平均水平;楚雄州分枝杆菌耐药性与患者的性别、年龄、民族及职业关系不大;楚雄市结核病总体耐药率及耐多药率高于全州平均水平。
Objective To study the drug resistance and variation of Mycobacterium tuberculosis in sputum specimens of patients with tuberculosis in Chuxiong Prefecture and provide technical basis for formulating tuberculosis prevention and treatment plan. Methods Mycobacteria cultured in sputum from patients with pulmonary tuberculosis in 10 counties (cities) in Chuxiong Prefecture from 2011 to 2015 were collected and tested for their mycobacterial type and anti-TB drug susceptibility. Results A total of 839 strains were collected and identified as mycobacteria, of which 92.85% were human, 2.14% were bovine and 5.01% were NTM. The drug resistance rates of each drug were 11.80% for INH, 7.51% for RFP, , EMB was 4.05%, KN was 5.36%, and OFX was 5.36%. The resistance rate of different types of drug resistance was 23.72%, the single drug resistance rate was 12.63%, the MDR- TB) was 5.24%, multidrug resistance rate was 5.84%, XDR-TB was 1.19%, resistance to second-line drug was 1.67%. Conclusions Mycobacterium tuberculosis is the predominant cause of tuberculosis in Chuxiong prefecture. Although NTM accounts for a relatively small proportion, the drug resistance rate is high; the XDR-TB prevalence in Chuxiong prefecture is higher than the national average; Mycobacterium drug resistance and the patient’s sex, age, ethnic and occupational relationships; Chuxiong tuberculosis overall resistance rate and multi-drug resistance rate higher than the statewide average.