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目的回顾性分析结核病患者对4种一线药物在7年间的总体耐药性及其变化趋势,了解结核病的耐药特征及变化规律,为结核病防治工作提供参考。方法 2006-2012年结核病患者送检的各类标本中分离出的结核分枝杆菌6 120株,均采用BACTEC960-TB液体培养法对链霉素(S)、异烟肼(H)、利福平(R)、乙胺丁醇(E)4种一线抗结核药物进行药敏试验,并应用SPSS软件进行数据统计,分析各年间耐药的变化规律及耐药趋势。结果 2006-2012年结核分枝杆菌的耐药率分别为40.89%、38.29%、28.85%、34.93%、29.97%、33.03%、37.19%;总耐药率34.17%,总单耐药率为13.27%,总多耐药率为8.17%,总耐多药率为12.73%;耐单药次序为H>S>R>E;耐2药次序为SH>HR>SR>HE>SE>RE;耐3药次序为SHR>SHE>HRE>SRE;耐药率排序为单药>2种>3种>4种。结论 2006-2012年单耐药率、多耐药率、耐多药率总体呈波浪式升高,但2010-2012年有持续升高趋势,以耐多药最为严重;应继续加强建立、完善结核病耐药监控系统,提高对耐多药结核病的治疗、督导和管理,预防耐多药结核病疫情的蔓延。
Objective To retrospectively analyze the overall drug resistance of tuberculosis patients to four kinds of first-line drugs in seven years and their changing trends, to understand the characteristics and the changing rules of drug resistance in tuberculosis so as to provide references for the prevention and control of tuberculosis. Methods Six hundred and sixty Mycobacterium tuberculosis isolates were collected from all kinds of specimens sent out by tuberculosis patients in 2006-2012. The antibacterial activity of streptomycin (S), isoniazid (H) (R), ethambutol (E) four kinds of first-line anti-tuberculosis drug susceptibility testing, and application of SPSS software for data statistics, analysis of resistance changes in the years and drug resistance trends. Results The resistance rates of Mycobacterium tuberculosis from 2006 to 2012 were 40.89%, 38.29%, 28.85%, 34.93%, 29.97%, 33.03% and 37.19%, respectively. The total resistance rate was 34.17% and the total single drug resistance rate was 13.27 %, The rate of total multidrug resistance was 8.17%, the total multidrug resistance rate was 12.73%; the order of resistance to single drug was H> S> R> E; the order of resistance to two drugs was SH> HR> SR> HE> SE> The sequence of resistance to 3 drugs was SHR> SHE> HRE> SRE; resistance was ranked as single drug> 2 species> 3 species> 4 species. Conclusions From 2006 to 2012, the single drug resistance rate, multidrug resistance rate and multidrug resistance rate all showed a wave-like increase. However, there was a continuous upward trend from 2010 to 2012, with the most serious being multi-drug resistance. The establishment and improvement of TB drug resistance surveillance system to improve the treatment, supervision and management of MDR-TB and prevent the spread of MDR-TB epidemic.