天津市一线抗结核药物的耐药变迁与临床督导机制的研究

发布时间：2019-01-05 03:16

【摘要】：目的回顾性分析结核病患者对4种一线药物在7年间的总体耐药性及其变化趋势,了解结核病的耐药特征及变化规律,为结核病防治工作提供参考。方法 2006-2012年结核病患者送检的各类标本中分离出的结核分枝杆菌6 120株,均采用BACTEC960-TB液体培养法对链霉素(S)、异烟肼(H)、利福平(R)、乙胺丁醇(E)4种一线抗结核药物进行药敏试验,并应用SPSS软件进行数据统计,分析各年间耐药的变化规律及耐药趋势。结果 2006-2012年结核分枝杆菌的耐药率分别为40.89%、38.29%、28.85%、34.93%、29.97%、33.03%、37.19%;总耐药率34.17%,总单耐药率为13.27%,总多耐药率为8.17%,总耐多药率为12.73%;耐单药次序为HSRE;耐2药次序为SHHRSRHESERE;耐3药次序为SHRSHEHRESRE;耐药率排序为单药2种3种4种。结论 2006-2012年单耐药率、多耐药率、耐多药率总体呈波浪式升高,但2010-2012年有持续升高趋势,以耐多药最为严重;应继续加强建立、完善结核病耐药监控系统,提高对耐多药结核病的治疗、督导和管理,预防耐多药结核病疫情的蔓延。
[Abstract]:Objective to analyze the overall drug resistance and its changing trend of TB patients in the past 7 years, to understand the characteristics and changes of drug resistance of tuberculosis, and to provide reference for TB prevention and treatment. Methods from 2006 to 2012, 6 120 strains of Mycobacterium tuberculosis were isolated from various specimens of tuberculosis patients. The streptomycin (S),) isoniazid (H),) rifampicin (R),) was isolated by BACTEC960-TB liquid culture method. Four first-line antituberculous drugs of ethambutanol (E) were tested for drug sensitivity, and the data were analyzed by SPSS software to analyze the change of drug resistance and the trend of drug resistance in each year. Results the drug resistance rates of Mycobacterium tuberculosis in 2006-2012 were 40.89 and 28.85, respectively. The total drug resistance rate was 34.17, the total monodrug resistance rate was 13.27, the total multi-drug resistance rate was 8.17, the total multi-drug resistance rate was 12.73am, the order of single drug resistance was HSRE; resistance 2 was SHHRSRHESERE; resistance, the order was SHRSHEHRESRE;. The order of drug resistance was 2 species, 3 species and 4 species. Conclusion from 2006 to 2012, the rates of single drug resistance, multi-drug resistance and multi-drug resistance increased in general, but in 2010-2012 there was a continuous upward trend, with the most serious multi-drug resistance. In order to prevent the spread of MDR-TB, we should continue to establish and improve the surveillance system of MDR-TB, improve the treatment, supervision and management of MDR-TB.
【作者单位】：天津市海河医院检验科;
【基金】：天津市科技攻关基金资助项目(10KG217)
【分类号】：R52

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