Drug resistance among retreatment tuberculosis patients in six provinces of China
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摘要: 目的 了解广东、湖北、河南、山东、内蒙、浙江6个省复治肺结核患者的耐药情况,为制定耐药结核病相关策略提供科学依据。方法 收集2008年1月-2010年12月广东、湖北、河南、山东、内蒙、浙江6个省筛查的7338例复治肺结核患者的基本情况、涂片、培养、药物敏感试验、菌种鉴定等信息,应用SPSS 12.0统计软件分析不同登记分类复治肺结核患者的耐药情况。结果 6个省筛查的7338例复治肺结核患者中,有7290例开展了痰培养检验,培养结果阳性5403例,并对培养阳性的患者全部开展药敏试验;药敏试验结果显示,复治肺结核患者任一耐药异烟肼耐药率为48.3%,利福平耐药率为45.8%,氧氟沙星耐药率为20.2%,卡那霉素耐药率为6.3%;复治肺结核患者耐多药率和广泛耐药率分别为36.6%和1.1%,其中复治失败患者耐多药率(56.3%)和广泛耐药率(3.0%)最高。结论 复治肺结核患者任一耐药率和耐多药率均处于较高水平,其中复治失败患者耐药率最高。Abstract: Objective To analyze the prevalence of drug resistance among retreatment pulmonary tuberculosis(TB) patients in 6 provinces of China and to provide evidences for making strategies on the control of drug-resistant TB.Methods Information on demographics,results of sputum smear,bacteria isolation and identification and drug sensitivity test(DST)for 7338 retreatment TB patients were collected from Guangdong,Hubei,Henan,Shandong,and Zhejiang province and Inner Mongolia Autonomous Region from January 2008 through December 2010.SPSS 12.0 was used to analyze differences in drug resistance among the patients.Results For all the retreatment TB patients,7290 had sputum culture for Mycobacterium tuberculosis detection,of which 5403 had positive results and DST was conducted for all positive specimens.For all the strains isolated,48.3% were resistant to isoniazid,45.8% to rifampin,20.2% to ofloxacin,and 6.3% to kanamycin and the ratio of multidrug resistant(MDR) and extensively drug resistant(XDR) were 36.6% and 1.1%,respectively.Among all the patients,those with ineffective medication had the highest prevalence of MDR(56.3%) and XDR(3.1%).Conclusion The prevalence of MDR and XDR are at a high level among retreatment TB patients and the prevalence is the highest among the retreatment patients with ineffective medication.
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Key words:
- pulmonary tuberculosis /
- drug resistance /
- retreatment
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[1] World Health Organization.Global tuberculosis report 2014[R].Gevena:World Health Organization,2014. [2] 中华人民共和国卫生部.全国结核病耐药性基线调查调查报告(2007-2008)年[M].北京:人民卫生出版社,2010:12. [3] 王宇.耐多药肺结核防治管理工作方案[M].北京:军事医学科学出版社,2012:8. [4] 肖东楼,赵明刚,王宇.中国结核病防治规划实施工作指南[M].北京:中国协和医科大学出版社,2009:42. [5] World Health Organization/International Union Against Tuberculosis and Lung Diseases.Guidelines for surveillance of drug resistance in tuberculosis:1997[S].Geneva:World Health Organization,1997. [6] 世界卫生组织.结核病定义和报告框架:2013年修订版[M].Geneva:World Health Organization,2014:5. [7] World Health Organization.Guidelines for surveillance of drug resistance in tuberculosis[M].4th.Geneva:World Health Organization,2009:5. [8] World Health Organization.The global plan to stop TB,2006-2015[M].Geneva:World Health Organization,2006:52. [9] 梁庆福,陈求扬,赵永,等.福建省结核病耐药性监测结果分析[J].中国公共卫生,2012,28(4):420-422. [10] World Health Organization.Guidelines for the programmatic management of drug-resistant tuberculosis-2008 urgent version[M].Geneva:World Health Organization,2008:28. [11] 周丽莎,耿文奎.结核病耐药原因分析[J].中国公共卫生,2009,25(5):524-526. [12] 孟素艳,范梦柏,王晶晶,等.肺结核患者结核病耐药性危险因素分析[J].中国公共卫生,2012,28(2):241-242.
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