目的：探析番禺地区结核分枝杆菌的耐药情况与耐药谱。方法选择2011年2月至2014年2月期间番禺地区就诊的结核病患者1033例，并对其分离株进行菌种鉴定。检测其对利福平（ RIF）、异烟肼（ INH）、链霉素（ SM）及乙胺丁醇（ EMB）的耐药性。并进一步分析对INH耐药的结核分枝杆菌的耐药谱分布情况。结果 1033株结核菌株中，总耐药率为42.01%（434/1033），其中，初始患者耐药率低于复治患者（40.32%比48.20%），两者耐药率具有统计学差异（χ2=4.440，P =0.035）。男性患者耐药率低于女性患者（37.18%比57.55%），两者耐药率具有统计学差异（χ2=31.826，P ＜0.01）。30˜60岁年龄段患者耐药率最高，＜30岁、30˜60岁和＞60岁3个年龄段耐药率（28.78%比48.31%比27.68%）比较差异有统计学意义（χ2=48.852，P ＜0.01）。所检测的RIF、INH、SM及EMB耐药顺序为INH （14.98%）＞RIF（13.36%）＞SM（9.11%）＞EMB（4.56%）。155株INH耐药株中，同时耐RIF的有46（29.68%）株，耐多药率为4.45%（46/1033）。结论番禺地区结核分枝杆菌的耐药情况较严重，与患者年龄、性别等有关，应加强对耐药杆菌的检测，采取有效的防控措施。%Objective To investigate drug -resistant situation and antibiogram of Mycobacterium tuberculosis( M. tuberculosis)in Fanyu. Methods During the time of February 2011 to February 2014,1 033 tuberculosis patients were selected and the isolates obtained from the patients were identified. The resistance of these isolates to rifampicin,isoniazid,streptomycin and ethambutol were tested and the antibio-gram were analyzed. Results The total drug-resistance rate of M. tuberculosis isolates was 42. 01%(434/1 033). The initial drug-resist-ance rate(40. 32%)was lower than acquired drug-resistance rate(48. 20%),the difference was statistically significant(χ2 =4. 440,P =0. 035). The drug-resistance rate in male(37. 18%)was lower than in female(57. 55%)(χ2 =31. 826,P <0. 01). The patients be-tween 30 and 60 years of age had highest resistance rate(48. 31%)than other age groups(χ2 =48. 852,P =0. 01). The resistance rates to isoniazid,rifampicin,streptomycin and ethambutol were 14. 98%,13. 36%,9. 11% and 4. 56%,respectively. Of the 155 isoniazid-resist-ant isolates,46(29. 68%)were also resistant to rifampicin and the multi-drug resistance rate was 4. 45%(46/1 033). Conclusion The drug resistance of M. tuberculosis in Fanyu was serious and we need to strengthen the detection of drug-resistant tuberculosis,and take effec-tive prevention and control measures.
展开▼
