论文部分内容阅读
目的掌握新疆维吾尔自治区喀什地区结核病患者耐药情况,为制定耐药结核病防治策略提供基础数据支持. 方法采取整群抽样方法收集新疆维吾尔自治区喀什地区8个县(市)2015年1月1日至12月31日期间新登记的涂阳患者1206例,其中经过菌种鉴定确定为结核分枝杆菌感染者共908例.采用比例法药物敏感性试验(简称“药敏试验”),分析908株菌株对利福平(RFP)、异烟肼(INH)、乙胺丁醇(EMB)、链霉素(Sm)、卡那霉素(Km)、阿米卡星(Am)、氧氟沙星(Ofx)和卷曲霉素(Cm)的耐药率及耐药谱情况.结果喀什地区结核分枝杆菌的总耐药率、单耐药率、多耐药率、耐多药率分别是21.48%(195/908)、15.42%(140/908)、3.52%(32/908)、3.30%(30/908).总耐药率顺位前4位者分别为: INH(10.35%,94/908)、Sm(9.36%,85/908)、RFP(7.38%,67/908)和Ofx(3.19%,29/908).对908株菌株进行上述8种药物的药敏试验,结果共有24种耐药谱组合,其中单耐药有8种组合,单耐Sm构成比最高为37.15%(52/140),其次是单耐INH,占31.43%(44/140);多耐药有7种组合,总多耐药组合构成比最高的是INH+Sm 53.13%(17/32);耐多药有9种组合,前3位的组合是INH+RFP 40.00%(12/30)、INH+RFP+Sm 23.34%(7/30)、INH+RFP+Ofx 16.68%(5/30).结论 新疆维吾尔自治区喀什地区结核病患者总体耐药水平较高,需进一步加强结核病防治工作,提高结核病患者诊断、治疗和管理质量,减少复治患者的产生. “,”Objective To explore the prevalence of drug-resistant tuberculosis (TB) in Kashgar region, and provide basic data support for the development of drug-resistant TB control strategies. Methods Sputum of 1206 newly registered smear-positive pulmonary TB patients from eight counties in Kashgar region between January 1, 2015 and December 31, 2015 were cultured and subject to drug susceptibility test.A total of 908 clinical isolates were identified as Mycobacterium tuberculosis (MTB) and tested using proportion method for susceptibility to eight anti-tuberculosis drugs: rifampin (RFP), isoniazid (INH), ethylamine butanol (EMB), streptomycin (Sm), kanamycin (Km), amikacin (Am), ofloxacin (Ofx), and curly mycin (Cm).The drug-resistance rates and drug resistance spectrum were analyzed. Results The total drug-resistance rate, mono-resistance rate, poly-resistance rate and multi-drug resistance rate of MTB in Kashgar were 21.48% (195/908), 15.42% (140/908), 3.52% (32/908) and 3.30% (30/908), respectively.The most common drug resistant to MTB was INH (10.35%, 94/908), followed by Sm (9.36%, 85/908), RFP (7.38%, 67/908) and Ofx (3.19%, 29/908).Results of drug susceptibility test on 908 clinical MTB isolates revealed there were 24 patterns of drug resistance.Among them, there were 8 patterns of mono-resistance, and the proportion of resistance to Sm ratio was the highest, which was 37.15% (52/140), followed by INH (accounting for 31.43% (44/140)).There were 7 types of poly-resistance, and the proportion of INH+Sm resistance pattern was the hightest (53.13%, 17/32).There were 9 patterns of multi-drug resistance, and the highest proportion was the pattern of INH+RFP (40.00%, 12/30), followed by INH+RFP+Sm (23.34%, 7/30)and INH+RFP+Ofx (16.68%, 5/30). Conclusion The prevalence for drug-resistant TB was high in kashgar, prevention and treatment of TB should be enhanced, diagnosis, treatment and management of TB should be strengthened to decrease retreated TB patients.