2011~2013年连云港市结核病耐药监测结果分析

摘要

Objective To analyze the drug resistance of tuberculosis in Lianyungang City , and to provide references for implemen-ting a evidence-based strategy for tuberculosis control and prevention .Methods Sputum samples collected from 1677 sputum smear positive tuberculosis cases who were diagnosed during 2011-2013 were cultured .Drug sensitivity to the commonly used first -line antitu-berculosis drugs were tested for 1521 Mycobacteria tuberculosis isolations.Results In Lianyungang city, the total drug resistance rate was 17.23%(12.67%in new cases;40.4%in previously treated cases).The rate of drug resistance to isoniazid was the highest , either in new cases (8.81%) or in previously treated cases (34.8%).The multi -drug resistance rate was 4.34% (2.20% in new cases;15.20%in previously treated cases ) .The multi-drug resistance rate varies with age and sex .Conclusion The risk of drug resistance is higher among retreated tuberculosis patients in Lianyungang .It is essential to implement standard antituberculosis therapy , strengthen the management of patients , prevent and control the occurrence and transmission of multi -drug resistant tuberculosis .%目的 分析江苏省连云港市结核病耐药现况,为制定有针对性的结核病防制策略提供参考. 方法 对连云港市2011~2013年确诊的1976例涂阳结核病患者进行痰菌培养,对分离出的1521株结核分枝杆菌进行4种一线抗结核药物耐药检测. 结果连云港市结核病总耐药率17.23%,其中初始耐药率12.67%,复治耐药率为40.4%. 初治组和复治组均以异烟肼(INH)耐药率最高,分别为8.81%和34.8%. 耐多药率为4.34%,其中初治患者耐多药率2.20%,复治患者耐多药率15.20%.不同年龄和性别的患者耐多药率差异具有统计学意义. 结论 连云港市复治结核病患者的耐药率较高,应规范结核病治疗方案,加强督导管理,预防和控制耐药结核病的发生和流行.