摘要
目的了解徐州市结核分枝杆菌的耐药情况。方法采用整群抽样的方法连续收集徐州市城区结核防治门诊2008年8月至2010年4月痰菌阳性的肺结核患者的痰标本193例,用比例法做一线药物(异烟肼、利福平、链霉素、乙胺丁醇)的敏感试验,耐多药的患者做二线药物(左氧氟沙星、阿米卡星、卷曲霉素、丙硫异烟胺)的敏感试验。结果符合条件并纳入调查的细菌有178株;178株结核分枝杆菌总的耐药率为38.8%,初治和复治耐药率分别为21.4%、72.1%,耐多药率为18.0%,初治和复治耐多药率分别为4.3%、44.3%,4种一线药物耐药顺序由高到低分别为耐异烟肼30.3%,耐链霉素29.2%,耐利福平22.5%,耐乙胺丁醇19.1%,复治患者对4种一线药物的耐药率明显高于初治患者;同时耐1种、2种、3种、4种药物的初治和复治耐药率分别为6.8%、8.5%、2.6%、4.3%,9.8%、14.8%、9.8%、29.5%,复治患者同时耐3、4种药物的耐药率明显高于初治者;32例耐多药患者对4种二线药物总耐药率为37.5%,耐药顺序由高到低分别为耐左氧氟沙星28.1%,耐丙硫异烟胺15.6%,耐阿米卡星12.5%,耐卷曲霉素6.3%。结论徐州市结核分枝杆菌整体耐药率仍处于高水平,各部门的结核病防治工作者应采取切实有效的措施,降低耐药结核病的发生。
Objective To analyze the drug resistance of Mycobacterium tuberculosis（MTB） in Xuzhou.Methods Cluster sampling method was used to collect 193 tuberculosis patients with sputum-positive during 2008-8 to 2010-4 in Xuzhou City.Proportion method was used to test the sensitivity of first-line drugs（isoniazid,rifampicin,streptomycin,ethambutol）,the sensitivity of second-line drugs（levofloxacin,amikacin,capreomycin,propylthiouracil isonicotinoyl amines） was tested for the patients with multi-drug resistant（MDR） tuberculosis.Results There were 178 isolates of bacteria included in the survey.The resistant rate to any drug was 38.8% in all MTB isolates,21.4% in 117 new cases and 72.1% in 61 previously treated cases.Multi-drug resistant rate was 18.0%.Initial and acquired MDR were respectively 4.3% and 44.3%.Any resistance to isoniazid,streptomycin,rifampicin and ethambutol was 30.3%,29.2%,22.5% and 19.1%,respectively.The resistant rate of 4 first-line drugs in patients with previously treated was significantly higher than that of untreated patients.The resistant rates to 1,2,3 and 4 drugs were 6.8%,8.5%,2.6% and 4.3% in initial cases and 9.8%,14.8%,9.8% and 29.5% in previously treated cases.The resistant rate of 3 or 4 contemporary drugs in patients with previously treated was significantly higher than that of untreated patients.The resistant rate to second-line drugs was 37.5% in 32 MDR cases.Drug resistance to levofloxacin,propylthiouracil isonicotinoyl amines,amikacin and capreomycin was 28.1%,15.6%,12.5% and 6.3%,respectively.Conclusion The drug resistant rate was still high in Xuzhou.Workers in various departments about TB should take effective active measures to reduce the incidence of drug-resistant TB.
出处
《临床荟萃》
CAS
2011年第8期666-668,共3页
Clinical Focus
基金
徐州市科技局立项课题(XM08C042)
关键词
分枝杆菌
结核
抗药性
微生物敏感性试验
流行病学研究
mycobacterium tuberculosis
drug resistance
microbial sensitivity tests
epidemiologic studies
