摘要
目的:分析武汉市全球基金结核病项目筛查患者耐药情况,为制定全市耐药结核病控制措施提供科学依据。方法:对2006年10月至2014年6月武汉市全球基金结核病项目筛查的5 524例涂阳肺结核痰标本进行培养、菌型鉴定和抗结核药物敏感性试验,对可疑耐多药结核病(MDR-TB)患者药敏结果进行统计分析。结果:武汉市全球基金结核病项目纳入对象结核分枝杆菌总耐药率为33.4%(1 627/4 870),单耐药率、多耐药率和耐多药率分别为12.8%(624/4 870)、8.4%(410/4 870)和12.2%(593/4 870)。初治患者耐药率(25.9%)低于复治耐药率(42.9%),差异有统计学意义(χ2=157.30,P<0.001)。初治患者多耐药率(6.7%,182/2 715)低于复治患者(10.6%,228/2 155),差异有统计学意义(χ2=23.42,P<0.001);初治患者耐多药率(6.9%,188/2 715)低于复治患者(18.8%,405/2 155),差异有统计学意义(χ2=158.26,P<0.001)。在单耐药中以耐S、H、O最多,检出率为4.7%、3.6%、2.7%,在多耐药中,以耐HS最多,检出率为4.3%。在耐多药中,以同时耐HRS最多,检出率为4.2%。结论:武汉市全球基金结核病项目筛查的涂阳肺结核患者MDR-TB检出率较高,耐多药肺结核防控形势严峻,预防其产生至关重要。
Objective：To analyze MTB resistance patterns from the Global Funds Tuberculosis（GF TB）project in Wuhan,a central China city,and to provide scientific basis for municipal control strategy for drug resistance TB.Methods：From October 2006 to June 2014,a total of 5 524 smear positive TB patients were screened for GF TB project in Wuhan.Sputum samples were taken smear culture,identified and tested for drug susceptibility（DST）,and then DST results were statistically analyzed as patterns of drug resistance.Results：The total drug resistance rate among these patients was 33.4%（1 627/4 870）.Rates of mono,poly and multi-drug resistance were 12.8%（624/4 870）,8.4%（410/4 870）and 12.2%（593/4 870）,respectively.Generally,new patients（25.9%）were of a lower rate of drug resistance when compared with retreatment or relapsed patients（42.9%）,which showed statistically significant difference（χ2=157.30,P〈0.001）.In terms of poly drug resistance,the drug resistance rate of new patients（6.7%,182/2 715）was lower than that of retreatment patients（10.6%,228/2 155）,and the difference was statistically significant（χ2=23.42,P〈0.001）.In terms of multi-drug resistance,new patients were still of a lower rate of drug resistance to retreatment patients,and the difference was statistically significant（χ2=158.26,P〈0.001）.Among patients with mono drug resistance,Streptomycin,Isoniazide and Ofloxacin resistance were the most prevalent,which the respective drug resistance rates were 4.7%,3.6% and 2.7%.Among poly-drug resistance patients,the combination of Isoniazide and Streptomycin resistance had the highest prevalence with a drug resistance rate of 4.3%.Among multi-drug resistance cases,the combination of Isoniazide,Rifampin and Streptomycin resistance had the highest prevalence with a drug resistance rate of 4.2%.Conclusion：Smear positive patients who have been screened by the Wuhan GF TB project show a moderately high detection rate of MDR-TB,MDR-TB control in Wuhan still has a long way to go,and effective prevention is very important.
出处
《武汉大学学报（医学版）》
CAS
2015年第6期930-934,共5页
Medical Journal of Wuhan University
基金
中国全球基金结核控制项目(编号:CHN-S10-G14-T)
武汉市卫生局项目(编号:WG13A04)
关键词
分枝杆菌
结核
抗药性
武汉市
Mycobacterium
Tuberculosis
Drug Resistance
Wuhan
