摘要
目的全面了解全省耐药结核病流行现状和特点,为制定和完善防控措施提供依据。方法通过二阶段随机抽样方法在全省抽取涂阳肺结核病例样本。以调查问卷获取患者临床信息,采用比例法对利福平(R)、异烟肼(H)、链霉素(S)、乙胺丁醇(E)、氧氟沙星(O)和卡那霉素(Km)等6种药物进行敏感性检测。结果 (1)本次调查发现非结核分枝杆菌感染45例,占全部培阳病例的2.2%,其中初治为28例,复治17例。(2)全省总耐药率为16.4%,继发耐药率(22.5%)高于原发耐药率(14.1%)(χ2=17.9,P<0.01);耐多药率达到4.9%,继发耐多药率(8.2%)高于原发耐多药率(3.6%)(χ2=13.6,P<0.01);28.9%的耐多药为广泛耐药,广泛耐药率达1.4%。(3)与1998年相比,全省涂阳肺结核总耐药率和总耐多药率分别下降16.2%和23.3%。(4)通过6种药物的药敏检测,共计发现结核病耐药谱型35种,包括单耐药5种、多耐药19种、耐多药12种(含广泛耐药2种)。结论 (1)广东省耐药结核病疫情总体呈现下降趋势,但耐药疫情仍然较重,面临耐多药、广泛耐药结核病的挑战。(2)结核病耐药谱呈多态性和复杂性,需采取更全面、更积极的干预措施遏制耐药结核病疫情。
Objective To understand the prevalence and characteristic of drug-resistant tuberculosis（DR-TB） in Guangdong province in order to provide evidence base for strategy development.Methods Smear positive PTB patients were sampled by two-stage random sampling methods.The clinical information of patients were collected through questionnaires and proportion methods were employed in drug susceptibility test（DST） for rifampicin,isoniazid,streptomycin,ethambutol,ofloxacin and kanamycin.Results 1）This study found a total of 45 cases of non-tuberculous mycobacteria infection,accounting for 2.2% of all culture positive cases,among which 28 were new smear positive cases and 17 were retreatment cases.2）The total drug-resistant rate（DRR） were 16.4%,acquired DRR（22.5%） were higher than primary DRR（14.1%）（χ2=17.9,P0.01）.Multidrug-resistant rate（MDRR） were 4.9%,with higher acquired MDRR（8.2%） than primary MDRR（3.6%）（χ2=13.6,P0.01）.28.9% of MDR-TB cases were proved to be extensively drug-resistant tuberculosis（XDR-TB） which were 1.4% of total.3） Compared with that of 1998,the DRR and MDRR were decreased by 16.2% and 23.3% respectively so far.4） Through the DST of six drugs,35 types of drug-resistant spectrum were found including 5 types of single DR,19 types of poly-resistant and 12 types of MDR（including 2 types of XDR-TB）.Conclusions 1）Although the DR-TB epidemic showed a overall downward trend,Guangdong province still have a high burden of DR-TB and face the challenge from MDR-TB and XDR-TB.2） The polymorphism and complexity of the drug resistance spectrum calls for a more urgent and more comprehensive interventions against the prevalence of DR-TB in Guangdong province.
出处
《中国防痨杂志》
CAS
2011年第7期393-399,共7页
Chinese Journal of Antituberculosis
基金
广东省医学科研基金项目(C2008006)
"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(2008ZX10003-007)
关键词
结核
肺
抗药性
细菌
问卷调查
广东省
Tuberculosis
pulmonary
Drug resistance
bacterial
Questionnaires
Guangdong province
