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目的探讨住院肺结核患者的耐药特征,为结核病防治工作提供参考。方法对2006年1月~2008年12月期间住院的痰样本结核分枝杆菌培养阳性肺结核患者的结核分枝杆菌对4种抗结核药物(INH、SM、EMB、RFP)的耐药性测定,并进行回顾性分析。结果 1 586株结核分枝杆菌总的耐药率为30.1%,初始耐药率和获得性耐药率分别为16.0%和56.1%;耐多药率为12.0%,其中初始耐多药率和获得性耐多药率分别为3.1%和28.6%;4种抗结核药物的耐药率从高到低分别为INH(22.5%)、RFP(17.0%)、SM(11.1%)和EMB(6.2%);耐1种、2种、3种和4种药物的初始耐药率和获得性耐药率分别为10.6%、3.8%、1.2%、0.5%和18.0%、19.2%、13.7%、5.2%,无论是获得性耐药率、耐多药率、耐1种、耐2种、耐3种和耐4种药均显著高于初始耐药率(P<0.005)。结论住院肺结核患者结核分枝杆菌总耐药率、获得性耐药率尚处于较高水平,获得性耐药更趋向于对多种药物耐药,尤其是获得性MDR-TB发生率较高,应引起注意,需采取综合防治措施降低耐药率。
Objective To investigate the drug resistance characteristics of hospitalized patients with pulmonary tuberculosis and provide references for the prevention and treatment of tuberculosis. Methods The drug resistance of Mycobacterium tuberculosis to four kinds of anti-tuberculosis drugs (INH, SM, EMB, RFP) in sputum samples of sputum from patients with positive Mycobacterium tuberculosis culture from January 2006 to December 2008 were determined. And a retrospective analysis. Results The total drug resistance rate of Mycobacterium tuberculosis in 1 586 strains was 30.1%, the initial drug resistance rate and the acquired drug resistance rate were 16.0% and 56.1% respectively, and the multidrug resistance rate was 12.0%. The initial multidrug resistance rate and The rates of acquired MDR were 3.1% and 28.6% respectively. The resistance rates of four anti-tuberculosis drugs were INH (22.5%), RFP (17.0%), SM (11.1%) and EMB %). The initial drug resistance and acquired drug resistance of 1, 2, 3 and 4 drugs were 10.6%, 3.8%, 1.2%, 0.5% and 18.0%, 19.2% and 13.7% 5.2%. The rates of acquired resistance, multidrug resistance, resistance to 1, resistance to 2, resistance to 3 and resistance to 4 were significantly higher than the initial resistance (P <0.005). Conclusion The total drug resistance rate and acquired drug resistance rate of Mycobacterium tuberculosis in hospitalized patients with tuberculosis are still at high levels. Acquired drug resistance is more likely to be resistant to many drugs, especially the high incidence of acquired MDR-TB, Should pay attention to the need to take comprehensive prevention and control measures to reduce drug resistance.