北京市朝阳区流动人口结核耐药性现状调查研究

摘要

目的 了解北京市朝阳区2006-2008年流动人口结核病的耐药状况.方法 收集2006年1月至2008年12月来北京市朝阳区结核病门诊部诊治的流动人口中所有新发感染和复诊治疗的痰培养阳性肺结核病例的标本371份,采用比例法对4种抗结核药物S、H、R、E做药物敏感试验.结果 2006年1月至2008年12月期间进行结核分枝杆菌耐药监测共371株,耐药菌株83株,总耐药率为22.4%(83/371),初始耐药率为17.5%(58/331),获得性耐药率62.5%(25/40),耐多药率为5.9%(22/371),初始耐多药率4.2%(14/331),获得性耐多药率20.0%(8/40).复治组的耐药率和耐多药率均高于初治组,差异有统计学意义(χ~2分别为39.020和13.210,P均<0.01).4种抗结核药的耐药率由高到低依次为:S(16.7%)、H(12.1%)、R(11.3%)、E(1.9%).其中初始耐药率由高到低依次为:S(13.3%)、H(8.8%)、R(8.2%)、E(1.8%),获得性耐药率由高到低依次为:S(45.0%)、H(40.0%)、R(37.5%)、E(2.5%).复治组对S、H、R 3种药物的耐药率均高于初治组,差异有统计学意义(χ~2分别为23.549、29.810和27.754,P均<0.01).结论 朝阳区近几年流动人口的结核耐药情况仍处于较高水平,今后应当根据流动人口的特点加强防治措施.%Objective To investigate the latest situation in the period 2006-2008 of drug resistance tuberculosis among migratory population in Chaoyang district of Beijing.Methods All sputum culture-positive specimens from migratory population were collected.Drug susceptibility of Mycobacterium tuberculosis to M,H,R and E were tested by proportion method.Results Drug susceptibility of 371 isolates from 2006-2008 were tested.Total drug resistance wag 22.4%(83/371),the primary drug resistance and the acquired drug resistance were 17.5%(58/331)and 62.5%(25/40)respectively.The multi-drug resistance was 5.9%(22/371);the primary multi-drug resistance was 4.2%(14/331)and acquired multi-drug resistance wag 20.0%(8/40).The drug resistance and multi-drug resistance were higher in treated cases than that in new cases.and the difference wag statistically significant(χ~2 was 39.020 and 13.210,P<0.01).The drug resistance to 4 anti-tuberculosis drugs from high to low was M(16.7%).H(12.1%),R(11.3%),E(1.9%).The primary drug resistance rate were 13.3%(S),8.8%(H),8.2%(R),1.8%(E).The acquired drug resistance rate were 45.5%(S),40.0%(H),37.5%(R),2.5%(E).The drug resistance to S,H and R were higher in treated cases than that in new cases,and the difference was statistically significant(χ~2 was 23.549,29.810 and 27.754,P<0.01).Conclusion The drug resistance to mycobacterium tuberculosis among migratory population was relatively high in chaoyang district of Beijing,suggesting the necessity to strength the tuberculosis control program for migratory population.