2018—2022年重庆市复治肺结核患者利福平耐药情况及影响因素

Rifampicin resistance and its influencing factors in re-treated pulmonary tuberculosis patients in Chongqing City from 2018 to 2022

摘要:

目的 分析重庆市复治肺结核患者利福平耐药情况及影响因素，为该市耐药结核病防控工作提供依据。 方法 应用描述性流行病学方法分析2018—2022年重庆市区县登记的复治肺结核患者利福平耐药情况，采用χ²检验及二元logistic回归分析复治肺结核患者耐药影响因素。 结果 2018—2022年该市区县复治肺结核患者利福平耐药检出率14.45%(558/3 862)，总体呈下降趋势(χ² _趋势=22.739，P < 0.001)。单因素分析显示复治肺结核患者中流动人口、居住在主城都市区、工人及民工患者利福平耐药检出率最高(均P < 0.05)，随年龄增加利福平耐药检出率降低(P_趋势 < 0.001)。多因素logistic回归分析显示，随着年龄增长，利福平耐药风险逐渐降低，OR值从 < 25岁组的2.778下降至45~岁组的1.654(均P < 0.001)。流动人口、居住在主城都市区、职业为工人及民工是复治肺结核患者利福平耐药的危险因素，差异均具有统计学意义(均P < 0.05)。 结论 虽然重庆市复治肺结核患者利福平耐药检出率逐年下降，但形势依然严峻，需重点关注流动人口、低龄、居住在主城都市区和工人及民工相关人群。

Abstract:

Objective To analyze the status and influencing factors of rifampicin resistance in re-treated pulmonary tuberculosis (PTB) patients registered in Chongqing City, and provide basis for the prevention and control of drug-resistant tuberculosis in this city. Methods Descriptive epidemiological method was adopted to analyze the status of rifampicin resistance in re-treated PTB patients registered in districts and counties of Chongqing City from 2018 to 2022. Chi-square test and binary logistic regression were used to analyze the influencing factors for the status of ri-fampicin resistance in re-treated PTB patients. Results The detection rate of rifampicin resistance in re-treated PTB patients in districts and counties of Chongqing City from 2018 to 2022 was 14.45% (558/3 862), presenting an overall downward trend (χ²_trend=22.739, P < 0.001). Univariate analysis showed that among re-treated PTB patients, the detection rate of rifampicin resistance was the highest among migrant population, residents in urban areas, workers, and migrant workers (all P < 0.05); rifampicin resistance decreased with the increase of age (P _trend < 0.001). Multivariate logistic regression analysis showed that the risk of rifampicin resistance gradually decreased with the increase of age; OR value decreased from 2.778 in the < 25 year old group to 1.654 in the ≥45 year old group (all P < 0.001). The risk factors for rifampicin resistance in re-treated PTB patients were migrant population, residents in urban areas, workers, and migrant workers, with statistically significant differences (all P < 0.05). Conclusion Although the detection rate of rifampicin resistance in re-treated PTB patients in Chongqing has been decreasing year by year, the situation is still severe, and special attention should be paid to the migrant population, young population, population in the main urban areas, and migrant workers.