许圆圆, 陈潇潇, 陈喜凯, 沈伟伟, 王可然, 林海江. 台州市2015—2017年涂阳肺结核病例耐药性分析[J]. 上海预防医学, 2018, 30(12): 1012-1015. DOI: 10.19428/j.cnki.sjpm.2018.18817
引用本文: 许圆圆, 陈潇潇, 陈喜凯, 沈伟伟, 王可然, 林海江. 台州市2015—2017年涂阳肺结核病例耐药性分析[J]. 上海预防医学, 2018, 30(12): 1012-1015. DOI: 10.19428/j.cnki.sjpm.2018.18817
XU Yuan-yuan, CHEN Xiao-xiao, CHEN Xi-kai, SHEN Wei-wei, WANG Ke-ran, LIN Hai-jiang. Drug resistance analysis on smear-positive pulmonary tuberculosis in Taizhou City from 2015 to 2017[J]. Shanghai Journal of Preventive Medicine, 2018, 30(12): 1012-1015. DOI: 10.19428/j.cnki.sjpm.2018.18817
Citation: XU Yuan-yuan, CHEN Xiao-xiao, CHEN Xi-kai, SHEN Wei-wei, WANG Ke-ran, LIN Hai-jiang. Drug resistance analysis on smear-positive pulmonary tuberculosis in Taizhou City from 2015 to 2017[J]. Shanghai Journal of Preventive Medicine, 2018, 30(12): 1012-1015. DOI: 10.19428/j.cnki.sjpm.2018.18817

台州市2015—2017年涂阳肺结核病例耐药性分析

Drug resistance analysis on smear-positive pulmonary tuberculosis in Taizhou City from 2015 to 2017

  • 摘要:
    目的了解浙江省台州市肺结核病例的耐药情况,为制定肺结核防控策略提供依据。
    方法对2015—2017年在台州市耐药监测点连续纳入的267例涂阳病例的痰标本,进行结核分枝杆菌培养、菌群鉴定。采用比例法药敏试验进行9种抗结核药物异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、链霉素(SM)、卡那霉素(KAM)、氧氟沙星(OFX)、卷曲霉素(CPM)、丙硫异烟胺(PTO)和对氨基水杨酸钠(PAS)的药物敏感性试验。
    结果267例病例中,送检培养220例,培养阳性190例(17例鉴定为非结核分枝杆菌感染),培养阴性28例,污染2例。160例有9种抗结核药物的药敏试验结果,总耐药率为22.5%,初治组耐药率为21.4%,复治组耐药率为33.3%,两组差异无统计学意义(P>0.05)。耐多药率为3.1%,初治组耐多药率为0.7%,复治组耐多药率为26.7%,两组差异有统计学意义(P < 0.01)。9种药物的耐药顺位依次为INH(8.1%)、PTO(8.1%)、SM(6.9%)、RFP(6.3%)、OFX(2.5%)、PAS(2.5%)、EMB(2.5%)、CPM(2.5%)和KAM(2.5%)。不同性别耐药率差异无统计学意义(P>0.05)。不同年龄组耐药率差异无统计学意义(P>0.05)。
    结论对台州市耐药结核病疫情仍需引起重视,特别是获得性耐多药疫情。须继续完善“三位一体”管理模式,提高临床诊疗质量,强化社区服药管理。

     

    Abstract:
    ObjectiveTo ascertain the drug resistance for pulmonary tuberculosis in Taizhou City, and to provide basis for tuberculosis prevention and control strategy.
    MethodsThe sputum samples were collected form 267 smear positive pulmonary tuberculosis patients who registered in a drug susceptibility testing (DST) monitoring site in Taizhou City form 2015 to 2017.Then with culture, identification of Mycobacterium and DST for 9 anti-tuberculosis drugs isoniazid (INH), rifampicin (RFP), ethambutanol (EMB), streptomycin(SM), kanamycin (KAM), ofloxacin (OFX), crinkledmycin (CPM), promethylamine (PTO) and para amino salicylate (PAS) by using proportion method performed on all sputum specimens.
    ResultsOf the 267 smear positive cases, 220 were cultured with 190 culture positive (17 were identified as nontuberculous mycobacterial infections), 28 culture negative, and 2 contaminated.Among 160 cases with the result of DST to 9 drugs, the overall drug resistance rate was 22.5%.The overall drug resistance rates were 21.4% and 33.3% in the newly diagnosed patients and retreated patients respectively.There was no significant difference between the two groups (P>0.05).The multidrug resistance rate was 3.1%, and had a significant difference between the new and retreated patients (0.7% vs.26.7%, P < 0.01).Drug resistances rates of the 9 drugs ranged from high to low as: INH (8.1%), PTO (8.1%), SM (6.9%), RFP (6.3%), OFX (2.5%), PAS (2.5%), EMB (2.5%), CPM (2.5%) and KAM (2.5%).There was no gender difference found in drug resistance rates (P>0.05).Neither was there age difference (P>0.05).
    ConclusionThe epidemic of drug-resistant of tuberculosis in Taizhou City are still high, especially that of acquired multi-drug resistance of tuberculosis.We must continue to improve the "three-in-one" management model, improve the quality of clinical diagnosis and treatment, and strengthen community medication management.

     

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