摘要
目的了解武汉市结核分枝杆菌的耐药流行状况及特点,为评价和完善结核病防治规划提供科学依据。方法以武汉市2010年3～8月连续登记的新发涂阳及复治涂阳肺结核患者作为调查对象,通过问卷调查获取患者临床信息,用比例法对异烟肼(H)、利福平(R)、乙胺丁醇(E)、链霉素(S)、卡那霉素(Km)和氧氟沙星(Ofx)6种药物进行敏感性检测。共纳入涂阳患者939例,经菌型鉴定结核分枝杆菌感染885例(初治涂阳688例、复治涂阳197例)。结果 885例结核分枝杆菌总耐药率22.4%(198/885),其中单耐药率9.7%(86/885)、多耐药率6.1%(54/885)、MDR-TB 6.2%(55/885)和XDR-TB 0.3%(3/885)。初治涂阳肺结核单耐药率9.0%(62/688)、多耐药率4.5%(31/688)、MDR-TB 4.2%(29/688)及XDR-TB 0.3%(2/688);复治涂阳肺结核单耐药率12.2%(24/197)、多耐药率11.7%(23/197)、MDR-TB 13.2%(26/197)及XDR-TB 0.5%(1/197)。发现29种耐药谱,包括单耐药5种、多耐药13种、MDR-TB(含XDR-TB)11种。结论首次获得了武汉市结核病耐药本底资料。武汉市结核病耐药率低于全国平均水平,但同样面临着MDR-TB和XDR-TB威胁。控制耐药结核疫情已经成为武汉市结核病防治规划的重要内容之一。
Objective To understand the epidemic status and characteristics of M.Tuberculosis drug resistance patterns in Wuhan city,so as to provide evidence for evaluating and improving TB control program.Methods Registry records between March and August of 2008 were collected,all new smear positive and newly registered retreatment smear positive patients were included for survey,questionnaires,patients＇ clinical data were collected;The proportional method was applied,6 drugs：Isoniazid,Rifampicin,Ethambutol,Streptomycin,Kanamycin,Ofloxacin were subjected to DST test（drug susceptibility test）.939 cases of smear positive were included,through serotype identification,885 cases were M.Tuberculosis（Mtb）.Results Among 885 cases of MTB,the overall rate of drug resistance was 22.4%（198/885）,and ratefor mono-drug was 9.7%（86/885）,6.1%（54/885）、MDR-TB 6.2%（55/885）for poly-resistance was 6.1%（54/885）,for multi-resistance was 6.2%（55/885） and extensive drug resistance was 0.3%（3/885）.The same rates for new smear positive patients were 9.0%（62/688）,4.5%（31/688）,4.2%（29/688） and 0.3%（2/688） respectively.Resistance rates for retreatment smear positive patients were 12.2%（24/197）,11.7%（23/197）,13.2%（26/197） and 0.5%（1/197）respectively.Of all the 6 drugs tested for drug susceptibility,29 resistance patterns were recognized,of which,5 patterns were of mono-resistance,13 patterns were of poly resistance,11 patterns were of multi-drug resistance（including extensive drug resistance）. ConclusionBaseline data and characteristics of TB drug resistance were for the first time obtained in Wuhan city.The TB drug resistance rates in wuahn city was below the national average,however,still facing the threat of MDR-TB and XDR-TB.The control of drug-resistant TB epidemic has become an important part of tuberculosis control program in Wuhan city.
出处
《公共卫生与预防医学》
2012年第4期33-38,共6页
Journal of Public Health and Preventive Medicine
基金
第五轮中国全球基金耐多药肺结核防治项目(CHN-S10-G14-T)
"十一五"国家重大科技专项(2009ZX10003-019)
关键词
结核
肺
抗药性
细菌
Tuberculosis
Pulmonary
Drug Resistance
Bacteria
作者简介
周美兰（1967-），女，公共卫生硕士，副主任医师，研究方向：结核病及耐多药结核病预防控制
通讯作者：王卫华，Email：drwang65@163．com
