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目的了解四川省结核分枝杆菌耐药状况,分析耐药趋势,为临床治疗和结核病防治规划提供科学依据。方法对四川省2010-07/2012-12开展耐药监测获得的1 313株结核分枝杆菌使用比例法进行异烟肼(INH)、链霉素(SM)、利福平(RFP)、乙胺丁醇(EMB)、卡那霉素(KM)和氧氟沙星(OFX)6种抗结核药的药物敏感实验。结果 1 313株结核分枝杆菌总耐药率为22.62%(297/1 313),其中初治涂阳患者总耐药率17.35%(185/1 066),复治涂阳患者总耐药率为49.34%(112/227),单耐药率为10.36%(136/1 313),多耐药率为4.27%(56/1 313),耐多药率为7.99%(105/1 313),其中5例广泛耐药菌株,广泛耐药率为0.38%(5/1 313);各种药物的耐药发生频率以INH最高,KM最低。结论与四川省2010年全国第五次结核病流行病学抽样调查数据相比,四川省结核病总耐药率、单耐药率、多耐药率均小幅下降,耐多药率上升,耐药率仍维持较高水平,提示四川省的耐药结核病防控工作面临的形势还很严峻,应继续加强结核病耐药监测与防治工作。
Objective To understand the drug resistance of Mycobacterium tuberculosis in Sichuan Province and analyze the trend of drug resistance so as to provide a scientific basis for clinical treatment and prevention and control of tuberculosis. Methods A total of 1 313 Mycobacterium tuberculosis isolates obtained from drug-resistant surveillance in Sichuan province from July 2010 to December 2012 were screened for isoniazid (INH), streptomycin (SM), rifampicin (RFP), and B Amine butanol (EMB), kanamycin (KM) and ofloxacin (OFX) six anti-TB drugs drug-sensitive experiments. Results The total drug resistance of 1 313 strains of Mycobacterium tuberculosis was 22.62% (297/1 313). The total drug resistance rate of smear-positive patients was 17.35% (185/1 066) The rate of multidrug resistance was 4.27% (56/1 313) and the rate of multidrug-resistant was 7.99% (105/1 313), with the rate of single drug resistance being 10.36% (136/1 313), 49.34% (112/227) , Of which 5 were widely drug-resistant strains, the rate of extensive drug resistance was 0.38% (5/1 313). The drug resistance rates of various drugs were highest in INH and lowest in KM. Conclusion Compared with the fifth national TB epidemiological survey in Sichuan Province in 2010, the total drug resistance rate, single drug resistance rate and multi-drug resistance rate of tuberculosis in Sichuan Province decreased slightly, the multi-drug resistance rate increased and the drug resistance rate Still maintain a high level, suggesting that the situation facing the prevention and control of drug-resistant TB in Sichuan is still very serious. We should continue to strengthen the monitoring and prevention of TB drug abuse.