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目的分析无锡市近年来活动性肺结核患者一线抗结核药物耐药特征,为临床选择治疗方案和防控政策的制定提供依据。方法收集2012—2015年期间送市结核病参比实验室的肺结核患者的痰培养阳性菌株,运用WHO/IUATLD推荐的比例法药敏试验测定结核分枝杆菌分离株对4种常用一线抗结核药的敏感性,对获得的结果进行分析。结果共收集2012—2015年期间无锡市活动性肺结核患者痰培养阳性结核分枝杆菌复合群菌株1 373株,其中1 171株(87.58%)对4种抗结核药物均敏感,166株(12.42%)对1种或1种以上一线抗结核药物药物耐药,单耐药率6.13%,耐多药率5.53%,多耐药率1.27%。4种抗结核药物耐药顺位由高到低依次为利福平(9.65%)、异烟肼(6.96%)、链霉素(2.92%)、乙胺丁醇(1.35%)。滨湖区耐药率和耐多药率高于其他地区。结论无锡市肺结核耐药水平较低,部分地区肺结核患者耐药情况较其他地区严重。需继续做好耐药结核病的监测工作,及时发现并治疗耐药肺结核患者。
Objective To analyze the drug resistance characteristics of first-line anti-tuberculosis drugs in patients with active pulmonary tuberculosis in recent years in Wuxi City, and to provide the basis for the clinical choice of treatment programs and prevention and control policies. Methods The positive sputum culture strains from patients with pulmonary tuberculosis who were sent to TB reference laboratories from 2012 to 2015 were collected. The proportion of Mycobacterium tuberculosis isolates tested against the four common first-line anti-TB drugs Sensitivity, the results obtained were analyzed. Results A total of 1 373 strains of sputum positive Mycobacterium tuberculosis complex were collected from Wuxi active tuberculosis patients during 2012-2015, of which 1 171 (87.58%) were sensitive to 4 anti-tuberculosis drugs and 166 (12.42% ) Were resistant to one or more first-line anti-TB drugs. The single-drug resistance rate was 6.13%, the multi-drug resistance rate was 5.53%, and the multi-drug resistance rate was 1.27%. The anti-tuberculosis drug resistance rankings of four anti-TB drugs were as follows: rifampin (9.65%), isoniazid (6.96%), streptomycin (2.92%) and ethambutol (1.35%). The resistance rates and MDR rates in the Lake District are higher than those in other areas. Conclusion The level of TB resistance in Wuxi is low, and the drug resistance of TB patients in some areas is more serious than in other areas. It is necessary to continue monitoring drug-resistant TB and promptly identify and treat patients with resistant TB.