375例耐多药肺结核二线抗结核药物敏感性状况分析

发布时间：2018-05-05 05:41

  本文选题：结核/肺 + 药物敏感试验　； 参考：《实用医学杂志》2014年14期

【摘要】：目的:了解耐多药结核分枝杆菌对氧氟沙星(Ofx)、卡那霉素(Km)二线抗结核药物的耐药情况,为耐药结核病疫情控制提供科学依据。方法:采用比例法检测375例耐多药肺结核患者临床分离株对Ofx、Km二线抗结核药物的耐药性,回顾性分析其耐药情况。结果:375例耐多药肺结核,对Km耐药占12.8%(48例),对Ofx耐药占39.73%(149例),对于Ofx、Km的两种二线抗结核药物同时耐药(XDR-TB)的比例达到8.53%(32例)。在不同登记分类耐多药肺结核病例二线药敏结果中,复治病例则对Ofx耐药明显高于初治。在XDR-TB病例中,复发、复治失败病例占75%,明显高于其他类别来源病例。结论:耐多药结核分枝杆菌菌株对二线抗结核药物具有较高的耐药率,有必要进一步加强实验室对二线抗结核药物敏感性的检测能力。同时应加强对肺结核患者的治疗管理,避免不规则治疗及药物滥用,及早控制广泛耐多药肺结核产生。
[Abstract]:Objective: to understand the drug resistance of multidrug resistant Mycobacterium tuberculosis (MTB) to ofloxacin (Ofx) and kanamycin (Km) second-line anti tuberculosis drugs, and to provide scientific basis for the control of the epidemic situation of drug-resistant tuberculosis. Methods: the resistance of 375 patients with multi drug resistant pulmonary tuberculosis to Ofx and Km second line anti tuberculosis drugs was analyzed by proportion method. Results: 375 cases of multidrug-resistant pulmonary tuberculosis accounted for 12.8% (48 cases) of Km resistance and 39.73% (149 cases) against Ofx, and 8.53% (32 cases) for Ofx and two second line anti tuberculosis drug resistance (XDR-TB) in Km. In the second line drug sensitivity results of different registered multi drug lung nodules, the retreated cases were significantly higher than those of Ofx. In XDR-TB cases, the recurrence and retreatment failed cases accounted for 75%, obviously higher than other types of sources. Conclusion: multi drug resistant Mycobacterium tuberculosis strains have high drug resistance rate to the second line anti tuberculosis drugs. It is necessary to further strengthen the laboratory's ability to detect the sensitivity of the second line anti tuberculosis drugs. Meanwhile, the patients with tuberculosis should be strengthened. The treatment and management should avoid irregular treatment and drug abuse, and control the occurrence of multidrug-resistant tuberculosis in an early stage.

【作者单位】： 广东省结核病控制中心;
【基金】：广东省医学科研基金项目(编号:A2013113) 中国全球基金结核病项目(编号:CHN-S10-G14-T)
【分类号】：R521
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本文编号：1846482