摘要
目的了解山东省高危人群耐多药肺结核筛查情况,探索并完善耐多药肺结核患者的发现策略。方法以耐多药肺结核5类高危人群(包括初治失败患者、复发与返回患者、复制失败患者、初治涂阳治疗2/3月末痰涂片阳性患者和其他与耐多药患者接触密切的涂阳患者)为主要筛查对象,进行结核菌培养和药敏试验,分析不同人群中耐多药肺结核的筛出情况。结果 2018年山东省登记高危人群肺结核可疑患者1 230例,完成耐药筛查1 138例,筛查率为92.52%。涂阳培阳率为62.21%,涂阳培阴率为26.63%,污染率为1.05%;其中复发患者涂阳培阳率最高,为65.55%,初治失败患者涂阳培阳率最低,仅为43.53%。培养阳性中有632例为结核分枝杆菌复合群,检出耐多药肺结核97例,检出率为15.35%,不同患者分类耐多药检出率差异总体上差异有统计学意义(P<0.01)。结论对重点人群优先进行筛查是非常有效的耐多药肺结核患者发现策略。
Objective To understand the screening situation of suspicious multi-drugresistant tuberculosis(MDR)cases in Shandong province,and explore the suitable strategy for MDR-TB case-finding.Methods 5 types of high-risk groups with multi-drug resistant tuberculosis(including initial treatment failure patients,relapse and return patients,replication failure patients,initial treatment smear positive patients at the end of 2/3 months and other smear positive patients in close contact with multi-drug resistant patients)were screened by the culture of tuberculosis bacteria and drug susceptible test,and the screening situation of multi-drug resistant pulmonary tuberculosis in different groups was analyzed.Results There were 1230 suspicious TB cases in high-risk population registered in Shandong province in 2018,and 1138 cases of drug resistance screening were completed,with a screening rate of 92.52%.The rate of smear-positive and culture-positive rate was 62.21%,the rate of smear-receiving was 26.63%,and the pollution rate was 1.05%.Among them,relapse cases had the highest rate of smear-positive,which was 65.55%;the culture positive rate of initial treatment failure was the lowest,which was only 43.53%.There were 632 positive cultures of mycobacterium tuberculosis complex group,97 cases of ultidrug-resistant tuberculosis were detected,the detection rate was 15.35%,and the difference in the detection rate of multidrug-resistant tuberculosis among different types of patients was statistically significant(P<0.01).Conclusion Screening priority of the key populations is an effective strategy for finding multi-drug resistant pulmonary tuberculosis patients.
作者
骆斌
程俊
孙晓英
初磊
石武祥
LUO Bin;CHENG Jun;SUN Xiao-ying;CHU Lei;SHI Wu-xiang(Shandong Province Chest Hospital,Jinan,Shandong,250101,China;不详)
出处
《预防医学论坛》
2020年第4期302-304,共3页
Preventive Medicine Tribune
关键词
肺结核
高危人群
耐药
筛查
Pulmonary tuberculosis
High risk groups
Drug resistant
Screening
