高级检索

浙江省杭州市肺结核患者耐药监测结果分析

李清春,  吴琍敏,  陆敏,  刘伟,  金晗英,  王乐,  王勐,  王珂

downloadPDF
文章导航 > 疾病监测  > 2014 >  29(3): 210-214
李清春, 吴琍敏, 陆敏, 刘伟, 金晗英, 王乐, 王勐, 王珂. 浙江省杭州市肺结核患者耐药监测结果分析[J]. 疾病监测, 2014, 29(3): 210-214. doi: 10.3784/j.issn.1003-9961.2014.03.012
引用本文: 李清春, 吴琍敏, 陆敏, 刘伟, 金晗英, 王乐, 王勐, 王珂. 浙江省杭州市肺结核患者耐药监测结果分析[J]. 疾病监测, 2014, 29(3): 210-214. doi: 10.3784/j.issn.1003-9961.2014.03.012
shu
LI Qing-chun, WU Li-min, LU Min, LIU Wei, JIN Han-ying, WANG Le, WANG Meng, WANG Ke. Surveillance for tuberculosis drug resistance in Hangzhou, Zhejiang[J]. Disease Surveillance, 2014, 29(3): 210-214. doi: 10.3784/j.issn.1003-9961.2014.03.012
Citation: LI Qing-chun, WU Li-min, LU Min, LIU Wei, JIN Han-ying, WANG Le, WANG Meng, WANG Ke. Surveillance for tuberculosis drug resistance in Hangzhou, Zhejiang[J]. Disease Surveillance, 2014, 29(3): 210-214. doi: 10.3784/j.issn.1003-9961.2014.03.012
shu

浙江省杭州市肺结核患者耐药监测结果分析

doi: 10.3784/j.issn.1003-9961.2014.03.012

Surveillance for tuberculosis drug resistance in Hangzhou, Zhejiang

    摘要
  • 摘要: 目的 了解杭州市耐药结核病疫情现状及特点，为及时调整杭州市结核病控制策略提供依据。方法 收集2011年杭州市登记所有涂阳患者痰标本，采用传统生化反应法进行菌型鉴定，采用世界卫生组织推荐的改良罗氏培养基比例法，进行异烟肼（Isoniazid，H）、利福平（Rifampicin，R）、乙胺丁醇（Ethambutol，E）、链霉素（Streptomycin，S）、氧氟沙星（Ofloxacin，O）和卡那霉素（Kanamycin，KM）的药物敏感性试验。利用结核病管理信息系统，收集患者人口学资料。结果 全年共报告1845例涂阳患者，开展痰培养并培养阳性1394例，其中菌群鉴定为结核分枝杆菌并有药敏试验结果者1184例。1184例患者中对4种一线抗结核药物（H、E、R、S）的总耐药率为31.33%，总耐多药率为11.57%。广泛耐药率为0.90%，其中耐多药患者中，耐氧氟沙星者占29.93%，耐卡那霉素者占3.65%。一线药物耐药率由高到低依次为H（19.51%）、S（17.15%）、R（16.98%）和E（5.07%），复治患者耐药率明显高于初治患者。结论 杭州市耐药结核病疫情相对较重，需进一步研究耐药病例合理的化疗方案，重点加强对初、复治患者的管理，从源头上减少耐多药甚至广泛耐药的发生。
    Abstract: Objective To investigate the prevalence of drug resistant tuberculosis (TB) in Hangzhou, Zhejiang provincec, and provide evidence for the revision of local TB control strategy. Methods Sputum samples were collected from all smear-positive TB patients registered in 2011 in Hangzhou and traditional biochemical reaction was done to identify the isolated strains. The strains' drug susceptibilities to Isoniazid, Rifampicin, Ethambutol, Streptomycin, Ofloxacin and Kanamycin were detected with modified Lowenstein-Jensen Culture Medium recommended by WHO. Results A total of 1845 smear-positive TB patients were registered in 2011, 1394 were culture positive, and 1184 were identified as Mycobacterium tuberculosis infections and had drug test results. Of the 1184 patients, 31.33% were resistant to at least one first-line drug, 11.57% were multi drug resistant (MDR), 0.90% were extensively drug resistant (XDR). Of the MDR patients, 29.93% were resistant to Ofloxacin, 3.65% were resistant to Kanamycin. The drug resistant rates to Isoniazid, Streptomycin, Rifampicin and Ethambutol were 19.51%, 17.15%, 16.98%, and 5.07%, respectively. The drug resistant rate in re-treated cases was significantly higher than that in new cases. Conclusion The prevalence of drug resistant TB was high in Hangzhou, It is necessary to improve the chemotherapy for drug resistant cases and strengthen the management of new cases and re-treated cases to reduce the incidence of MDR-TB or XDR-TB.
    • HTML全文
    • 参考文献(9)
  • [1] ZhaoYL,XuSF,WangLX,etal.Nationalsurveyofdrug-resistanttuberculosisinChina[J].TheNewEnglandJournalofMedicine,2012,366:2161-2170.
    [2] LiuYH,JiangGL,ZhaoLP,etal.DrugresisitanceofMycobacteriumtuberculosisinanationalwideepidemiologicalsurveyinChinaintheyear2000[J].ChineseJournalofTuberculosisandRespiratoryDiseases,2002,25(4):224-227.(inChinese)刘宇红,姜广路,赵立平,等.第四次全国结核病流行病学抽样调查-结核分枝杆菌耐药性分析与评价[J].中华结核和呼吸杂志,2002,25(4):224-227.
    [3] YuM,CheY,PingGH,etal.Trendsandimpactfactorsofdrug-resistanttuberculosisinNingbofrom2007to2010[J].ChineseJournalofInfectiousDisease,2012,30(1):48-52.(inChinese)于梅,车洋,平国华,等.2007年至2010年宁波市结核病耐药趋势及影响因素[J].中华传染病杂志,2012,30(1):48-52.
    [4] LiuZW,HeHB,WangXM,etal.Analysisofthethirddrugresistant-tuberculosissurveillanceinZhejiangprovince[J].ChineseJournalofPreventivemedicine,2011,45(2):171-173.(inChinese)柳正卫,何海波,王晓萌,等.浙江省第三次结核病耐药性监测结果分析[J].中华预防医学杂志,2011,45(2):171-173.
    [5] WuLL,HuY,ZhaoQ,etal.Prevalenceofdrug-resistanttuberculosisanditssocialandbiologicalriskfactorsinfiveruralcountiesofeasternChina[J].ChineseJournalofInfectiousDisease,2011,29(12):729-734.(inChinese)吴琳琳,胡屹,赵琦,等.我国东部农村五县耐药结核病流行及其社会学和生物学的危险因素[J].中华传染病杂志,2011,29(12):729-734.
    [6] WangYW,ZhangXY,HuPP,etal.AnalysisofMDRandXDRdistributioninthepastdecadeinChongqing[J].ChineseJournalofInfectiousDisease,2010,28(10):633-635.(inChinese)王易伟,张西雁,胡频频,等.重庆地区耐多药和广泛耐药结核病耐药性分布十年数据初步分析[J].中华传染病杂志,2010,28(10):633-635.
    [7] LiuQ,ZhuLM,ShaoY,etal.RatesandriskfactorsfordrugresistancetuberculosisinnortheasternChina[J].BMCPublicHealth,2013,13:1171.
    [8] AlenaS,HenadzH,AksanaZ,etal.Multidrug-resistanttuberculosisinBelarus:thesizeoftheproblemandassociatedriskfactors[J].BullWorldOrgan,2013,91:36-45.
    [9] ZhuJF,WangWB,WangXC,etal.Epidemicpatternofdrug-resistanttuberculosisanditsriskfactorsinDeqingcounty[J].ZhejiangJournalofPreventiveMedicine,2009,21(9):6-8.(inChinese)朱建福,王伟炳,王学才,等.德清县耐药肺结核流行情况及危险因素研究[J].浙江预防医学,2009,21(9):6-8.
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  1739
  • HTML全文浏览量:  45
  • PDF下载量:  408
  • 被引次数: 0
出版历程
  • 收稿日期:  2013-11-08
  • 刊出日期:  2014-03-20

目录

    /

    返回文章
    返回

    在线交流
    您是第位访问者！
    版权所有 © 2008 中国疾病预防控制中心传染病预防控制所 疾病监测编辑部
    地址：北京昌平区昌百路155号 邮编：102206 电话：010-58900732 Email：jbjc@icdc.cn
    京ICP备11024750号

    本系统由 北京仁和汇智信息技术有限公司 开发 技术支持： info@rhhz.net

    x 关闭 永久关闭

    防诈骗公告

    近期有不法分子以本刊编辑身份添加作者微信，请务必提高警惕！本刊关于稿件的一切事项通知均采用编辑部唯一邮箱（jbjc@icdc.cn）和座机（010-58900732）联系作者，且在录用稿件后仅收取版面费，无其他任何名目费用（如审稿费和加急费等），非编辑部邮箱发送的本刊收费用通知等均为诈骗，不要随意汇入款项！如有可疑及时致电编辑部核实确认！