湖北省襄阳市肺结核患者耐药状况调查.docVIP

湖北省襄阳市肺结核患者耐药状况调查 刘晓敏，范明宽，谢兵，王贤，袁霞 【摘要】：目的 了解襄阳市结核病耐药现状，为襄阳市结核病防治提供科学依据。方法 采取横断面调查，对2013年3月1日至12月31日在襄阳市结核病防治院确诊的568例痰培养阳性肺结核患者进行调查。患者的痰培养阳性标本采用比例法进行药物敏感性试验（异烟肼、利福平、乙胺丁醇和链霉素）；采用对硝基苯基酸(PNB)培养法鉴定结核分枝杆菌复合群，获得药物敏感试验结果的519例。利用SAS9.2软件中(2检验对耐药患者的性别和年龄因素进行分析。结果 共收集568例痰培养阳性标本，其中519例为结核病分枝杆菌菌株，占91.4%（519/568）；药敏检测结果显示519例肺结核病患者中耐药134例，总耐药率25.8%（134/519），其中，单耐药12.7%（66/519）,耐多药7.7%（40/519）,多耐药5.4%（28/519）；40例耐多药患者中，同时耐4种药物（HRES）的占到40.0%(16/40),其次为同时耐HRS占35.0%（14/40），在耐利福平的患者中，耐多药患者的比例占到69.0%（40/58），在耐异烟肼的患者中，耐多药患者比例为49.4%（40/81）；在检测的4种一线抗结核药品中，耐药率从高到低依次为SM(17.5%)、INH（15.6%）、RFP（11.2%）和EMB（5.4%）。男女肺结核患者耐药率和耐多药率无统计学差异（(2 =0.003、0.610; P=0.960、0.436）；60岁及以上肺结核患者耐药率低于60岁以下患者（(2 =0.57, P=0.0183），耐多药率在两年龄组间无差别（(2 =2.898, P=0.089）。结论 襄阳市结核病耐药疫情不容乐观，需要采取针对性措施加以防控。 【关键词】：结核，肺/预防和控制 ；抗药性，细菌；襄阳市 Investigation on pulmonary tuberculosis patients for drug-resistant status in Xiangyang city of Hubei province LIU Xiao-min, FAN Ming-kuan, XIE Bing, WANG Xian , YUAN Xia. Hospital for tuberculosis control and prevention of Xiangyang city in Hubei province, Xiangyang 441003, China 【Abstract】 Objective To understand the status of drug-resistant tuberculosis(TB) in Xiangyang city, to provide scientific evidences for tuberculosis control. Methods A across-sectional survey was carried out. 568 pulmonary TB patients who’s sputum cultured positive were enrolled in this study. Drug susceptibility testing of 4 first-tier anti-TB drugs(INH, RFP, EMB, SM) was performed using proportion method; Mycobacterium tuberculosis (Mtb) identification was done by p-nitrobenzoic(PNB) acid cultivation, 519 case were identified; (2 test was used with SAS9.2 to analyze the factor of sex and age on drug-resistant TB occur. Results The overall drug-resistant (DR-TB) rate in Xiangyang was 25.8%(134/519), in which, the rate of single DR-TB was 12.7%(66/519), multi-drug resistant (MDR-TB) 7.7%(40/519); the rate of MDR-TB reached 69.9%(40/58) among the RFP drug resistant cases. Mtb were 17.5% (33/519)、15.