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目的分析深圳市自2006年10月启动耐多药结核病防治项目以来至2015年12月期间耐多药肺结核患者发现和接受治疗的情况,以期为调整我市的耐多药结核病综合防控策略提供相关依据。方法从结核病信息管理系统中收集我市自2006年10月至2015年12月期间登记的全部耐多药肺结核可疑者的痰涂片、培养、药敏及纳入治疗情况等资料,计算不同登记分类可疑耐多药肺结核病患者痰培养阳性率、耐多药肺结核病检出率以及确诊耐多药肺结核病患者纳入治疗率。结果自2006年10月至2015年12月,共登记可疑耐多药肺结核病患者9 624例;开展了痰结核分枝杆菌培养2 886例,其中痰培养阳性率58.5%;开展传统药敏试验1 635例,耐多药肺结核检出率为23.4%;确诊的431例耐多药肺结核病患者中,在我中心接受二线抗结核药物治疗124例,纳入治疗率仅28.8%。结论耐多药肺结核高危人群(复治失败、初治失败、复发、返回、初治3月末涂阳)的检出率均远高于新患者,说明不规则治疗是造成耐药发生的重要原因;且确诊耐多药肺结核患者纳入治疗情况十分不理想,耐药结核病疫情控制形势严峻,尚需进一步加强对肺结核患者的督导管理以及对医务人员和肺结核患者的健康教育,控制疫情蔓延。
Objective To analyze the case finding and treatment of MDR-TB patients in Shenzhen since the start of MDR-TB prevention and control project in October 2006 and December 2015, with a view to provide a guideline for the adjustment of the comprehensive anti-tuberculosis multi-drug control strategy in our city Related basis. Methods The data of sputum smear, culture, drug susceptibility and treatment of all MDR-TB suspects registered in our city from October 2006 to December 2015 were collected from the TB information management system, and the data of different registration categories Suspicious MDR-TB patients sputum culture positive rate, multidrug-resistant pulmonary tuberculosis detection rate and the diagnosis of MDR-TB patients included in the treatment rate. Results A total of 9 624 suspicious MDR-TB cases were registered from October 2006 to December 2015. A total of 2 886 cases of sputum Mycobacterium tuberculosis were cultured, of which sputum culture positive rate was 58.5%. A traditional susceptibility test 1 635 cases, the detection rate of MDR-TB was 23.4%. Of the 431 cases of MDR-TB confirmed, 124 cases received second-line anti-TB drugs in our center and the treatment rate was only 28.8%. Conclusions The detection rates of MDR-TB patients at high risk (failure of retreatment, initial failure, relapse, return, smear at the beginning of March) are much higher than that of new patients, indicating that irregular treatment is an important cause of drug resistance ; And the diagnosis of multidrug-resistant tuberculosis patients admitted to treatment is very unsatisfactory situation, drug-resistant tuberculosis control the situation is grim, still need to further strengthen the supervision and management of tuberculosis patients and medical staff and tuberculosis patients health education, control the spread of the epidemic.