2013－2018年浙江省丽水市结核病患者一线抗结核药物耐药分析

陈秀英; 徐丽霞; 柳付明; 武劼; 邱理杨; 凡鹏飞; 李秋华

doi:10.3784/j.issn.1003-9961.2020.03.014

2013－2018年浙江省丽水市结核病患者一线抗结核药物耐药分析

Surveillance results of first-line anti-tuberculosis drug resistance in tuberculosis patients in Lishui, Zhejiang, 2013–2018

摘要

摘要:
目的了解2013 — 2018年浙江省丽水市结核病患者对一线抗结核药物的耐药情况，为结核病疫情控制提供参考依据。
方法收集2013—2018年浙江省丽水市结核病病例，分离菌株并进行菌型鉴定，测定结核分枝杆菌对异烟肼、利福平、链霉素、乙胺丁醇4 种一线抗结核药物敏感性。
结果共测定1 883株结核分枝杆菌的耐药性，其中初治肺结核患者1 770株，复治肺结核患者113株，总耐药率为17.15%，耐多药率为5.74%。初始耐药率是15.42%（273/1 770），低于获得性耐药率的44.25%（50/113）；初治肺结核患者耐药顺位链霉素＞异烟肼＞利福平＞乙胺丁醇；复治患者耐药顺位为异烟肼＞利福平＞链霉素＞乙胺丁醇。
结论丽水市肺结核患者总的耐药率和耐多药率低于全省及全国耐药基线调查及丽水市上一轮的监测数据，但是耐多药形势仍较为严峻。

Abstract:
ObjectiveTo understand the resistance of the first-line anti TB drugs in tuberculosis (TB) patients in Lishui, Zhejiang province, and provide reference basis for TB prevention and control.
MethodsThe Mycobacterium tuberculosis strains collected from 2013 to 2018 were identified and tested for the sensitivity to isoniazid, rifampicin, streptomycin and ethambutol.
ResultsThe drug resistance of 1 883 strains of M. tuberculosis was detected, the strains were from 1 770 newly treated pulmonary TB cases and 113 retreated pulmonary TB cases. The overall drug resistance rate was 17.15% and the multidrug resistance rate was 5.74%. The drug resistance rate in newly treated pulmonary TB cases was 15.42% (273/1 770), lower than that in retreated TB cases (44.25%, 50/113). In newly treated pulmonary TB cases, the resistance rate to streptomycin was highest, followed by isoniazid, rifampicin and ethambutol. In retreated pulmonary TB cases, the resistance rate to isoniazid was highest, followed by rifampicin, streptomycin and ethambutol.
ConclusionThe overall drug resistance rate and multidrug resistance rate in pulmonary TB cases in Lishui were lower than province and national baseline level and the level in last round surveillance in Lishui, but the multidrug resistance of TB was still serious.

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