摘要
目的 分析福建省耐多药结核病（MDR-TB）患者临床分离菌株对吡嗪酰胺（PZA）的耐药情况,为MDR-TB的防治工作提供科学依据。方法 收集2008—2010年福建省疾病预防控制中心在结核病耐药监测期间获得的119例MDR-TB患者的临床分离菌株及其患者基本信息,患者平均年龄（45.8±15.3）岁,男性占76.5%（91/119）,流动人口占30.3%（36/119）,农民占55.5%（66/119）,小学及以下学历的患者占53.8%（64/119）。以标准株H37Rv作对照,采用BACTEC TM MGIT 960 TM系统（简称“MGIT 960”）和WHO推荐的比例法在固体L-J培养基上对菌株进行PZA及其他抗结核药物的敏感性试验（简称“药敏试验”）。采用SPSS 17.0软件对数据进行描述性分析,计数资料的比较采用χ 2检验,以P〈0.05为差异有统计学意义。 结果 119株临床分离的耐多药菌株对PZA的耐药率达37.0%（44/119）。不同人口学特征的MDR-TB患者间仅小学及以下学历者对PZA的耐药率（26.6%,17/64）低于小学以上学历者（49.1%,27/55）（χ 2=6.44,P=0.011）;对乙胺丁醇、链霉素、氧氟沙星、左氧氟沙星、莫西沙星耐药的患者对PZA的耐药率分别为48.6%（36/74）、44.9%（31/69）、62.5%（20/32）、63.3%（19/30）、71.4%（10/14）,明显高于对上述药物敏感者对PZA的耐药率[分别为17.8%（8/45）、26.0%（13/50）、27.6%（24/87）、28.1%（25/89）、32.4%（34/105）]（χ 2=11.44,P=0.001;χ 2=4.46,P=0.035;χ 2=12.24,P〈0.001;χ 2=11.96,P=0.001;χ 2=8.08,P=0.004）。 结论 在福建省MDR-TB防治工作中,需重视对吡嗪酰胺的药敏试验检测,及时给予患者更加有效的治疗方案。
Objective To analyze the pyrazinamide （PZA） resistance in multidrug-resistant Mycobacterium tuberculosis （MDR-TB） clinical isolates in Fujian province.Methods A total of 119 MDR-TB clinical isolates and the basic information of MDR-TB patients were collected during the antituberculosis drug resistance surveillance in Fujian Center for Disease Control and Prevention from 2008 to 2010. The average age of the patients was （45.8±15.3） years, of which 76.5% （91/119） were male, 30.3% （36/119） were floating population, 55.5% （66/119） were peasants, and 53.8% （64/119） were patients with primary school education or below. Using the standard strain H37Rv as the control, the BACTEC TM MGIT 960 TM system （MGIT 960） and the proportional method recommended by the WHO were used to perform the drug susceptibility test of PZA and other antituberculosis drugs on strains in the L-J solid medium. The descriptive analysis of data was performed by SPSS 17.0, and the Chi square test was used on enumeration data. P〈0.05 was considered statistically significant. Results Of these 119 MDR-TB clinical isolates, 44 were detected resistant to PZA （37.0%）. Among the MDR-TB patients with different demographic characteristics, the PZA resistance rate of patients with primary school education or below （26.6%, 17/64） was lower than those with above primary school education （49.1%, 27/55） （χ 2=6.44, P=0.011）. The PZA resistance rates in patients with ethambutol, streptomycin, ofloxacin, levofloxacin and moxifloxacin resistance was 48.6% （36/74）, 44.9% （31/69）, 62.5% （20/32）, 63.3% （19/30）, and 71.4% （10/14）, respectively; which was significantly higher than that of sensitive patients （17.8% （8/45）, 26.0% （13/50）, 27.6% （24/87）, 28.1% （25/89）, and 32.4% （34/105））（χ 2=11.44, P=0.001; χ 2=4.46, P=0.035; χ 2=12.24, P〈0.001; χ 2=11.96, P=0.001; χ 2=8.08, P=0.004）. Conclusion We should pay more attention to the PZA susceptibility test to provide tim
作者
周银发
张山鹰
魏淑贞
林勇明
赵永
林建
林淑芳
ZHOU Yin-fa;ZHANG Shan-ying;WEI Shu-zhen;LIN Yong-ming;ZHAO Yong;LIN Jian;LIN Shu-fang.(Department of Tuberculosis Prevention and Control, Fujian Center for Disease Control and Prevention, Fuzhou 350001, China)
出处
《结核病与肺部健康杂志》
2018年第2期123-127,共5页
Journal of Tuberculosis and Lung Health
基金
福建省医学创新课题(2014-CXB-8,2015-CXB-10)
福建省卫生系统中青年骨干人才培养项目(2016-ZQN-21)
关键词
分枝杆菌
结核
结核
抗多种药物性
吡嗪酰胺
数据说明
统计
福建省
Mycobacterium tuberculosis
Tuberculosis
multidrug-resistant
Pyrazinamide
Data inter-pretation
statistical
Fujian province
