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目的分析南京市耐多药肺结核患者的发现和纳入治疗情况,为制定针对性的防治策略提供科学依据。方法2013年1月-2016年12月,对涂片阳性的慢性和复治失败、复治、初治2、3月末阳性患者及耐多药肺结核的密切接触者开展培养和药敏试验,分析不同人群中耐多药肺结核的检出情况。结果共筛查耐多药肺结核可疑者2 389例,培养阳性率64.54%。药敏试验1 383例,确诊耐多药肺结核患者144例,检出率10.41%。其中,复治失败检出率最高52.94%,各登记分类患者检出率差异有统计学意义((χ~2=29.24,P<0.001)。男性耐多药检出率10.81%高于女性9.09%。青壮年、中年及60岁~组耐多药检出率较高,各年龄组检出率差异有统计学意义(χ~2=44.13,P<0.001)。各区耐多药检出率在2.97%~20.61%之间,差异有统计学意义(χ~2=48.72,P<0.001)。耐多药肺结核患者纳入治疗率79.86%。结论南京市耐多药肺结核检出率高于全国,患者产生与登记分类、性别、年龄及地区有关,在耐多药防治工作中应重点考虑。
Objective To analyze the detection and treatment of MDR-TB patients in Nanjing and provide a scientific basis for the development of targeted prevention and treatment strategies. Methods From January 2013 to December 2016, culture and antimicrobial susceptibility tests were performed on smear-positive patients with chronic and re-treatment failure, retreatment, patients with positive disease at the end of 2 and 3 months and close contacts with multidrug-resistant pulmonary tuberculosis Detection of MDR-TB in different populations. Results A total of 2 389 MDR-TB suspicious patients were screened, and the positive rate of culture was 64.54%. Susceptibility test 1 383 cases, diagnosed 144 cases of multidrug-resistant tuberculosis patients, the detection rate was 10.41%. Among them, the detection rate of retreatment failure was the highest (52.94%), and there was a significant difference in the detection rate of each registration (χ ~ 2 = 29.24, P <0.001) .The detection rate of MDR in males was 10.81% .The detection rate of multi-drug resistant group was higher in young, middle-aged and 60 years old group, the detection rate of each age group was statistically significant (χ ~ 2 = 44.13, P <0.001) .The detection rate of multidrug- % ~ 20.61%, the difference was statistically significant (χ ~ 2 = 48.72, P <0.001) .In the treatment of multidrug-resistant pulmonary tuberculosis patients, the treatment rate was 79.86% .Conclusion The detection rate of multidrug-resistant pulmonary tuberculosis in Nanjing is higher than that of the whole country Production and registration classification, gender, age and region related, in the multi-drug prevention and control should be given priority to consider.