西安市结核分枝杆菌耐药基线调查

Baseline survey on drug resistance of Mycobacterium tuberculosis in Xi’an city

摘要:

目的了解西安市肺结核患者的耐药疫情及初始耐药与获得性耐药的耐药情况，为耐药结核病的治疗以及控制模式提供依据。方法将2015年西安市14个区（县）结核病门诊和西安市胸科医院所有初治及复治痰结核分枝杆菌培养阳性的病例作为研究对象，进行4种一线抗结核药物的敏感性试验。结果西安市结核分枝杆菌总耐药率为31.9%，耐多药（MDR）率为7.0%。初治组耐药率为27.3%，MDR率为3.5%。复治组耐药率为59.5%，MDR率为28.6%，复治组耐药率与MDR率均明显高于初治组，差异均有统计学意义（均P＜0.001）。结论西安市肺结核患者总耐药率低于全国平均水平，但MDR率略高于全国水平，说明西安市结核病防控工作虽然取得一定成效，但形势依然严峻，特别是要加强初治患者的管理以减少耐药结核病的发生。

Abstract:

ObjectiveTo investigate the baseline condition of initial and acquired drug resistance in patients with pulmonary tuberculosis in Xi’an city, and provide a scientific basis for the prevention and control of drugresistant tuberculosis.MethodsPatients with positive Mycobacterium tuberculosis(MT) culture and received initial treatment and retreatment in tuberculosis clinics of 14 districts (counties) in Xi’an  and Xi’an Chest Hospital in 2015 were included in the study, antimicrobial susceptibility testing of 4 kinds of firstline antituberculosis drugs were performed.ResultsThe overall drug resistance rate of MT in Xi’an city was 31.9%, multidrug resistance rate (MDR) was 7.0%. Drug resistance rate and MDR in initial treatment group were 27.3% and 3.5% respectively, in retreatment group were 59.5% and 28.6% respectively, drug resistance rate and MDR in retreatment group were both higher than initial treatment group (both P<0.001).ConclusionThe overall drug resistance rate of pulmonary tuberculosis patients in Xi’an city is lower than the whole nation, but MDR is slightly higher than the national level, although TB prevention and control work has achieved some success, the situation is still serious, the management of patients with initial treatment should be strengthened to reduce the occurrence of drug resistance.