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目的分析中国澳门地区2001至2005年结核病的耐药情况。方法选取近5年澳门地区新发结核病患者及复治结核病患者结核分枝杆菌分离株进行4种抗结核药物(异烟肼、利福平、链霉素、乙胺丁醇)的耐药性测定。结果 1460株结核分枝杆菌的总耐药率为16.2%(236株),其中初始和获得性耐药率分别为15.0(203/1357)和32.0(33/103);耐多药率为3.2%(47/1460),其中初始和获得性耐多药率分别为2.3%(31/1357)和15.5%(16/103);4种抗结核药物的耐药率由高到低依次为异烟肼(11.5%)、链霉素(9.5%)、利福平(3.6%)、乙胺丁醇(2.5%);耐1种、2种、3种和4种药物的初始耐药率分别为9.9%、2.9%、1.0%和1.2%,获得性耐药率分别为12.6%、3.9%、8.7%和6.8%。近5年新发和复治患者的耐药率没有上升趋势(X~2值分别为0.27和0.03,P 均>0.05);不同性别和年龄组间初始耐药率的差异无统计学意义(X~2=5.7,P>0.05)。结论本次流行病学调查结果与1996至1999年澳门地区结核病流行病学调查资料比较,获得性耐药率和获得性耐多药率显著下降,差异有统计学意义(X~2值分别为6.04和7.47,P 均<0.05),但初始耐药率和获得性耐药率高于2004年第3次全球多国耐药监察结果,仍处于高耐药水平,尤其是耐多药率较高的问题,应引起重视。
Objective To analyze the drug resistance of tuberculosis in Macao, China from 2001 to 2005. Methods Four new anti-tuberculosis drugs (isoniazid, rifampicin, streptomycin, ethambutol) were selected for the resistance of Mycobacterium tuberculosis isolates from newly diagnosed tuberculosis patients and retreatment tuberculosis patients in Macao in recent five years. Determination. Results The total drug resistance rate of 1460 Mycobacterium tuberculosis strains was 16.2% (236 strains), of which the initial and acquired resistance rates were 15.0 (203/1357) and 32.0 (33/103), respectively. The multidrug resistance rate was 3.2 % (47/1460). The rates of initial and acquired MDR were 2.3% (31/1357) and 15.5% (16/103), respectively. The resistance rates of the four anti-tuberculosis drugs were descended from high to low The initial drug resistance rates of 1, 2, 3 and 4 drugs were as follows: nicotine (11.5%), streptomycin (9.5%), rifampin (3.6%) and ethambutol Were 9.9%, 2.9%, 1.0% and 1.2% respectively, and the acquired resistance rates were 12.6%, 3.9%, 8.7% and 6.8% respectively. The rates of drug resistance in newly diagnosed and retreatment patients in the recent five years did not increase (X ~ 2 values were 0.27 and 0.03, respectively, P> 0.05). There was no significant difference in the initial drug resistance rates between different sexes and age groups X ~ 2 = 5.7, P> 0.05). Conclusions Compared with the epidemiological data of tuberculosis in Macao from 1996 to 1999, the prevalence of acquired and multidrug-resistant rates in this epidemiological survey was significantly lower with statistically significant differences (X ~ 2 values were 6.04 and 7.47, P <0.05), but the initial drug resistance rate and acquired drug resistance rate were higher than the results of the third global surveillance of multi-drug resistance in 2004. The drug resistance rate was still high, especially the high rate of multi-drug resistance The issue should be taken seriously.