论文部分内容阅读
目的分析2010-2012年常山县涂阳肺结核患者结核分枝杆菌的耐药情况与耐药谱。方法对2010年1月-2012年12月在常山县人民医院(浙江省结核病定点医院)结核门诊诊断、治疗的涂阳肺结核病例的痰进行结核分枝杆菌培养,菌型鉴定为结核分枝杆菌的菌株采用比例法进行6种抗结核药物[异烟肼(H)、利福平(R)、乙胺丁醇(E)、链霉素(s)、左氧氟沙星(O)、卡那霉素(KM)]耐药性测试。结果 260株结核分枝杆菌病例中,总耐药率17.31%,初始耐药率和获得性耐药率分别为11.16%和55.56%,两者差异具有统计学意义(χ2=45.75,P<0.01);耐药类型,单耐药率为8.85%,多耐药率为3.08%,耐多药率为4.62%,广泛耐药率为0.77%。耐药率最高为H11.15%,S 9.23%;初治涂阳单耐药率顺位前2位是H(6.70%)和S(6.25%),而复治涂阳单耐药率顺位前2位是H(38.89%)和(36.11%);多耐药谱,初治涂阳以H+S常见,复治涂阳以R+O,H+S+O常见;耐多药谱以H+R,H+R+S常见。结论常山县总耐药率、耐多药率、初始耐药率分别低于全国第五次结核病流调的结果,获得性耐药率和耐多药率则高于全国第五次结核病流调的结果。
Objective To analyze the drug resistance and drug resistance spectrum of Mycobacterium tuberculosis in smear-positive pulmonary tuberculosis patients from 2009 to 2012 in Changshan County. Methods Mycobacterium tuberculosis was isolated from sputum of smear-positive pulmonary tuberculosis diagnosed and treated in Changshan County People’s Hospital (Zhejiang Provincial TB TB Hospital) from January 2010 to December 2012. The mycobacteria were identified as Mycobacterium tuberculosis (H), rifampicin (R), ethambutol (E), streptomycin (s), levofloxacin (O), kanamycin (KM)] resistance test. Results Among the 260 Mycobacterium tuberculosis cases, the total drug resistance rate was 17.31%, the initial drug resistance rate and the acquired drug resistance rate were 11.16% and 55.56%, respectively, with statistical significance (χ2 = 45.75, P <0.01) ). The types of drug resistance were 8.85% for single drug resistance, 3.08% for multidrug resistance, 4.62% for multidrug resistance and 0.77% for multidrug resistance. The highest resistance rates were H11.15% and S 9.23%, respectively. The first two positive resistance rates were H (6.70%) and S (6.25%), The first two digits were H (38.89%) and (36.11%). Multidrug resistance spectrum was common in newly diagnosed smear positive H + S and retaliation smear positive was R + O and H + S + O. MDR Spectrum with H + R, H + R + S common. Conclusion The total drug resistance rate, multidrug resistance rate and initial drug resistance rate in Changshan County were lower than those of the fifth national TB control program respectively. The acquired drug resistance rate and multidrug resistance rate were higher than those of the fifth national TB program the result of.