摘要
目的进一步了解绵阳市结核分支杆菌的耐药情况及其变化趋势,为制定耐多药结核病控制策略及临床规范用药提供参考依据。方法用比例法对绵阳市9个县(市)区结核病专业防治机构2014-2015年推送的1 018例结核病病人的阳性菌株进行一线抗结核药物异烟肼(Isonicotinic acid hydrazide,INH)、利福平(Rifampicin,RFP)、链霉素(Streptomycin,SM)、乙胺丁醇(Ethambutol,EMB)和二线药物氧氟沙星(Ofloxacin,OFX)、卡拉霉素(Kalamycin,K)的耐药性监测,用鉴别培养基对硝基苯甲酸(P-nitrobenzoic acid,PNB)对结核分枝杆菌进行初步鉴定。结果除去11株非结核分枝杆菌外,剩余1 007株菌总耐药率为19.46%(196/1 007),耐多药率为5.96%(60/1 007),多耐药率为3.67%(34/1 007);与绵阳市2012-2013年比较,初治病人耐多药率有所下降(P<0.05),复治病人耐多药率差异无统计学意义;组合耐药方面以同时耐异烟肼、利福平和同时耐异烟肼、利福平、链霉素以及异烟肼、利福平、链霉素、乙胺丁醇为多。结论 2014-2015年绵阳市结核分枝杆菌的耐多药情况仍然严重,应加强对结核初诊病人特别是复治病人的治疗和管理,谨慎使用链霉素,预防耐药病人尤其是耐多药病人的产生和传播。
Objective To understand the condition and the change trendency of Mukidrug - resistant tuberculosis （ MDR - TB）, in order to supply some evidences of Tuberculosis（TB） remedy and control. Methods Use ratio method to detect the resistance of posi- tive strains which from 1 018 patients of tuberculosis were taken from 9 counties in Mianyang City, the antituberculotics including some first -line drug such as INH, RFP, SM, EMB and some second -line drug such as OFS and K; and use the indicator culture -me- dium to detect PNB. Results There was 1 007 MTBs, the rate of total resistance was 19. 46% （196/1 007）, and the rate of Muhidrug -resistant tuberculosis（MDR -TB） was 5.96% （60/1 Off7）, the rate of polyresistant was 3.67% （34/1 007） ; compared with the city of Mianyang from 2012 to 2013, the drug resistance rate of the newly diagnosed patients decreased（P 〈0. 05） ; the difference was not statistically significant. The MTBs both resistant INH and RFP were as much as resistant INH, RFP and SM, and same as resistant INH, RFP, SM and EMB. Conclusion The MDR -TB was still critical. The suggestion is that enhancing the standard treatments for new patients and re treatment patient, and using the SM restrainedly, meanwhile advancing the treatment and administration for new patients, preventing the production and extension of resistant patients.
作者
乔刚
周良君
王乐
杨红
QIAO Gang ZHOU Liangjun WANG Yue YANG Hong(Mianyang City Center for Disease Control and Prevention, Sichuan 621000 , China)
出处
《医学动物防制》
2017年第6期628-630,634,共4页
Journal of Medical Pest Control
基金
全球基金耐多药项目(项目序列号:CHN-S10-G14-T
项目编号:CHN-SSF-TB-26)
关键词
结核分枝杆菌
耐药监测
结果分析
Mycobacterium tuberculosis
Resistant monitoring
Result analysis
