2012-2016年常熟地区244例耐药肺结核高危人群耐药性监测分析

发布时间：2018-03-06 11:43

本文选题：结核病　切入点：药敏试验　出处：《现代预防医学》2017年18期 　论文类型：期刊论文

【摘要】：目的分析常熟地区耐药肺结核高危人群的耐药监测结果,为该地区耐药肺结核病的防治提供参考。方法收集2012-2016年常熟地区4类耐药肺结核高危人群(治疗2、3个月末痰涂片阳性、初治失败、复发、复治失败)痰涂片阳性标本,进行菌型鉴定和对异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)进行药敏试验,分析其耐药谱。结果2012-2016年常熟地区共发现318例耐药肺结核高危人群,其中244例鉴定为结核分枝杆菌感染,且获得药敏试验结果。244株结核分枝杆菌中共有78株被判断为耐药株(总耐药率为32.0%),其中单耐药率15.6%、多耐药率2.9%、耐多药率13.5%。耐药患者以男性、农民、50岁以上者为主。对4种抗结核药中任意1种的耐药率由高到低的排序是HRSE;共发现10种耐药谱,其中单耐药以耐S为主(19.2%),多耐药以耐H+S为主(7.7%),耐多药以H+R+S为主(15.4%)。结论常熟地区耐药肺结核高危人群的总耐药率为32.0%,其中以老年男性农民患者为主,耐药谱以耐S、耐H+S和耐H+R+S为主。
[Abstract]:Objective to analyze the results of drug resistance surveillance in high risk groups of drug-resistant pulmonary tuberculosis in Changshu, and to provide reference for the prevention and treatment of drug-resistant pulmonary tuberculosis in this area. Methods four high risk groups of drug-resistant pulmonary tuberculosis in Changshu from 2012 to 2016 were collected (sputum smear positive at the end of 2,3 months after treatment). The positive specimens of sputum smear were identified and susceptibility tests were carried out for isoniazid, rifampicin, streptomycin and ethambutanol. Results 318 cases of high risk population of drug-resistant pulmonary tuberculosis were found in Changshu area from 2012 to 2016, 244 of which were identified as Mycobacterium tuberculosis infection. The results of drug sensitivity test showed that 78 strains of Mycobacterium tuberculosis were judged to be resistant (total drug resistance rate was 32. 0%, including single drug resistance rate 15. 6%, multidrug resistance rate 2. 9%, multidrug resistance rate 13. 5%). The order of resistance rate of any one of the 4 antituberculotic drugs was HRSE, and 10 drug resistance spectra were found. Among them, the single drug resistance is mainly S resistance, the multidrug resistance is H S, the multidrug resistance is H S, and the multidrug resistance is H R S, which is 15.40.Conclusion the total drug resistance rate of the high risk population of drug-resistant pulmonary tuberculosis in Changshu is 32.0%, among which the elderly male farmers are the main ones. Resistance to S, H S and H R S were the main drug resistance patterns.
【作者单位】：南京医科大学公共卫生学院;江苏省常熟市第二人民医院;
【基金】：江苏高校品牌专业建设工程资助项目(编号:PPZY2015A067)
【分类号】：R521

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