缪梓萍, 何海波, 柳正卫, 杨石波, 郑锦雷, 刘北斗. 浙江省初始耐药结核病流行趋势[J]. 疾病监测, 2009, 24(3): 187-189. DOI: 10.3784/j.issn.1003-9961.2009.03.012
引用本文: 缪梓萍, 何海波, 柳正卫, 杨石波, 郑锦雷, 刘北斗. 浙江省初始耐药结核病流行趋势[J]. 疾病监测, 2009, 24(3): 187-189. DOI: 10.3784/j.issn.1003-9961.2009.03.012
MIAO Zi-ping, HE Hai-bo, LIU Zheng-wei, YANG Shi-bo, ZHENG Jin-lei, LIU Bei-dou. Epidemic trend of initial drug-resistant tuberculosis in Zhejiang province[J]. Disease Surveillance, 2009, 24(3): 187-189. DOI: 10.3784/j.issn.1003-9961.2009.03.012
Citation: MIAO Zi-ping, HE Hai-bo, LIU Zheng-wei, YANG Shi-bo, ZHENG Jin-lei, LIU Bei-dou. Epidemic trend of initial drug-resistant tuberculosis in Zhejiang province[J]. Disease Surveillance, 2009, 24(3): 187-189. DOI: 10.3784/j.issn.1003-9961.2009.03.012

浙江省初始耐药结核病流行趋势

Epidemic trend of initial drug-resistant tuberculosis in Zhejiang province

  • 摘要: 目的了解浙江省初始耐药结核病疫情现状和变化趋势,评价现行结核病控制策略的效果。方法按世界卫生组织《结核病耐药监测指南》(WHO/IUATLD)的要求对新登记初治涂阳肺结核病例进行耐药结核病监测,并与浙江省1998/1999年第1次耐药监测结果进行比较。结果30个监测点共入选结核病例936例,对834株结核分枝杆菌进行4种抗结核药物[链霉素(S)、异烟肼(H)、利福平和乙胺丁醇(E)]的耐药性测定,初始耐药率为26.6%,初始耐多药率为3.7%。初治耐药病例中, 65.8%仅对1种药物耐药,4种药物的耐药率顺位由高到低依次为: S(19.2%)、H(12.4%)、R(5.0%)、E(4.0%), 对1种和2种及以上药物的初始耐药率分别为17.5%和9.0%。与1998/1999年相比,全省初始耐药率上升显著(I/Isup2/sup=34.606,IP/I=0.000),耐多药率水平则呈现下降趋势, 结核分枝杆菌耐药性发生更趋向于耐单一药。结论浙江省初始耐多药结核病情况虽有所改善,但初始耐药结核病疫情依然严峻,进一步提高结核病控制质量是当务之急。

     

    Abstract: ObjectiveTo investigate the current status and trend of initial drug-resistant tuberculosis epidemic in Zhejiang province, and evaluate the effect of current TB control strategies. MethodsThe drug-resistant tuberculosis surveillance was performed for newly registered smear-positive tuberculosis cases in Zhejaing province according to the Guidelines for Surveillance of Drug-resistance in Tuberculosis by World Health Organization (WHO/IUATLD), and the results were compared with the first resistance surveillance in 1998/1999. ResultsA total of 936 TB cases were recruited from 30 surveillance spots. The resistance of 834 strains of Mycobacterium tuberculosis to four anti-TB drugs, streptomycin (S), isoniazid (H), rifampicin and ethambutol (E) was tested. The initial drug resistance rate was 26.6%, and the initial multi-drug resistance rate was 3.7%. In initial drug-resistant cases, 65.8% were resistance to only one drug. The resistance rates to 4 anti-TB drugs ranked as follows: 19.2% for S, 12.4% for H, 5.0% for R and 4.0% for E. The initial resistance rates to 1 drug and to 2 drugs were 17.5% and 9.0%, respectively. Compared with the records in 1998/1999, the initial drug resistance rates increased significantly in the province (I/Isup2/sup = 34.606, IP/I=0.000), while multidrug resistance rate showed a decreasing trend. Mycobacterium tuberculosis tended to show single drug resistance. ConclusionDespite some alleviation, initial drug-resistant tuberculosis epidemic was still serious in Zhejiang, so it is necessary to improve the quality of DOTS.

     

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