宋宏, 王春蒲, 康宏云. 2016-2020年山西省耐药结核病流行情况分析[J]. 疾病监测, 2023, 38(8): 924-928. DOI: 10.3784/jbjc.202209150400
引用本文: 宋宏, 王春蒲, 康宏云. 2016-2020年山西省耐药结核病流行情况分析[J]. 疾病监测, 2023, 38(8): 924-928. DOI: 10.3784/jbjc.202209150400
Song Hong, Wang Chunpu, Kang Hongyun. Epidemiological analysis of drug-resistant tuberculosis in Shanxi from 2016 to 2020[J]. Disease Surveillance, 2023, 38(8): 924-928. DOI: 10.3784/jbjc.202209150400
Citation: Song Hong, Wang Chunpu, Kang Hongyun. Epidemiological analysis of drug-resistant tuberculosis in Shanxi from 2016 to 2020[J]. Disease Surveillance, 2023, 38(8): 924-928. DOI: 10.3784/jbjc.202209150400

2016-2020年山西省耐药结核病流行情况分析

Epidemiological analysis of drug-resistant tuberculosis in Shanxi from 2016 to 2020

  • 摘要:
      目的   了解2016—2020年山西省耐药结核病的流行情况,为制定山西省耐药结核病防控政策提供科学依据。
      方法  利用“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中,收集2016—2020年登记的病原学阳性肺结核患者的耐药筛查情况、耐药检出情况及综合确诊结果等相关数据,对山西省耐药结核病流行情况进行描述性分析。
      结果   2016—2020年山西省共登记病原学阳性肺结核患者16214例,结核分枝杆菌培养阳性菌株8075株,总耐药率为11.49%(928/8075),耐多药率为8.54%(690/8075),单耐药率为1.93%(156/8075),多耐药率为0.80%(65/8075),广泛耐药率为0.21%(17/8075)。 总耐药率(趋势χ2=276.329,P<0.001)、耐多药率(趋势χ2=297.186,P<0.001)、广泛耐药率(趋势χ2=6.300,P<0.05)均呈下降趋势。 复治患者的总耐药率[23.89%(308/1289)]和耐多药率[18.23%(235/1289)]均明显高于初治患者[总耐药率为9.14%(620/6786) ,耐多药率为6.70%(455/6786)],差异均有统计学意义(χ2=231.95,P<0.001;χ2=184.155,P<0.001)。 近5年耐药患者发现数逐年上升,且以初治患者、中青年和农民等为主要发病群体,耐药菌株耐药谱逐渐复杂化,单耐药(MR)菌株以利福平(R)耐药菌为主,耐多药(MDR)菌株以异烟肼+利福平(H+R)、异烟肼十利福平十链霉素(H+R+S)为主,初治患者中共出现异烟肼十利福平+链霉素+乙胺丁醇+氧氟沙星(H+R+S+E+OF)联合耐药株16株。
      结论   山西省耐药结核病防控形势依然严峻,应强化中青年、农民等重点人群结核病的防控意识,规范临床用药,加强肺结核患者健康管理,避免或减少耐药结核病的发生。

     

    Abstract:
      Objective   This study aimed to understand the epidemic status of drug-resistant tuberculosis (DR-TB) in Shanxi Province in recent 5 years, and to provide scientific basis for the formulation of DR-TB prevention and control policies in Shanxi province.
      Methods   The drug-resistance screening, drug-resistance detection and comprehensive diagnosis results of patients with positive etiological tuberculosis registered from 2016 to 2020 were collected from tuberculosis Information Management System, a sub-system of China Disease Control and Prevention Information System, and to conduct a descriptive analysis of the prevalence of DR-TB in Shanxi Province.
      Results  A total of 16214 patients with etiologically positive pulmonary tuberculosis were registered in Shanxi province from 2016 to 2020, and 8075 strains of Mycobacterium tuberculosis were cultured positive. The total drug resistance rate, multi-drug resistance rate, single drug resistance rate, poly-resistance rate, and extensively drug-resistance rate of 8075 strains were 11.49%(928/8075), 8.54%(690/8075), 1.93%(156/8075), 0.80%(65/8075) and 0.21%(17/8075), respectively. In recent 5 years, the total drug resistance rate and multi-drug resistance rate and extensively drug-resistance rate showed a downward trend (trends χ2=276.329, P<0.001; trends χ2=297.186, P<0.001; trends χ2=6.300, P<0.05). The total drug resistance rate 23.89% (308/1289) and the multi-drug resistance rate 18.23% (235/1289) of the retreated patients were significantly higher than those of the untreated patients the total drug resistance rate was 9.14% (620/6786), and the multi-drug resistance rate was 6.7% (455/6786), and the difference was statistically significant (χ2=231.95, P<0.001; χ2=184.155, P<0.001).In recent 5 years, the number of drug-resistant tuberculosis patients has been increasing year by year, the main groups are initial treated patients, young and middle-aged people and farmers. the spectrum of drug resistant tuberculosis became more complicated, and the single drug resistant strains were mainly rifampicin-resistant bacteria, while the multi-drug resistant strains were mainly H+R and H+R+S, and 16 strains were H+R+S+E+OF in initial treated patients.
      Conclusion   The prevention and control situation of drug-resistant tuberculosis in Shanxi Province is still severe. The awareness of tuberculosis prevention and control dearing young and middle-aged people and farmers should be strengthen, standardize clinical drug use, and strengthen the health management of tuberculosis patients to avoid or reduce the occurrence of drug-resistant tuberculosis.

     

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