浙江省宁波地区974例初治肺结核病例耐药情况分析

车洋; 于梅; 平国华

doi:10.3784/j.issn.1003-9961.2010.08.008

浙江省宁波地区974例初治肺结核病例耐药情况分析

Analysis of drug resistance of 974 new tuberculosis cases in Ningno, Zhejiang province

摘要

摘要: 目的初步了解浙江省宁波地区初治肺结核病例耐药情况,对现行结核病控制策略效果进行评价。方法按照世界卫生组织《结核病耐药监测指南》(WHO/IUATLD)的要求对初治病例痰培养阳性菌株进行异烟肼、利福平、链霉素和乙胺丁醇4种抗结核药物的敏感性测定及菌群鉴定。结果研究共纳入结核分枝杆菌974株,初治患者总耐药率为29.8%,耐多药率为5.0%。初治耐药病例中,18.5%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链霉素(18.5%)、异烟肼(16.7%)、利福平(6.7%)、乙胺丁醇(5.2%)。与1999年耐药监测初治患者总耐药率17.8%相比,宁波市初治患者总耐药率上升差异有统计学意义(2=13.463,P＜0.005),耐多药率水平也呈现升高趋势,结核分枝杆菌耐药性发生更趋向于单一耐药。结论宁波地区结核病耐药形势依然严峻,需进一步加强结核病防治工作。

Abstract: Objective To investigate the drug resistance of new tuberculosis (TB) cases in Ningbo and evaluate the effect of current TB prevention and control strategies. Methods The drug-resistant surveillance was performed among newly registered smear-positive tuberculosis cases in Ningbo according to the surveillance guide of WHO (WHO/IUATLD). The drug resistances of strains of Mycobacterium tuberculosis isolated from them to streptomycin, isoniazid, rifampicin and ethambutol were detected. Results A total of 974 strains of Mycobacterium tuberculosis were detected. The overall drug resistant rate was 29.8%, and the multi-drug resistant rate was 5.0%. Among these cases, 18.5% were resistant to single drug. The resistant rate was 18.5% to streptomycin, 16.7% to isoniazid, 6.7% to rifampicin and 5.2% to ethambutol. Compared with the record in 1999 (17.8%), the overall drug resistant rate increased significantly (2=13.463, P0.005), multi-drug resistant rate showed a increasing trend too, but single drug resistance was more frequently detected. Conclusion The drug resistance of TB cases was serious in Ningbo, so it is necessary to strengthen the TB prevention and control

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