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目的了解结核分枝杆菌对一线抗结核药物的耐药性,初步评价嘉兴市近年来结核病的耐药趋势。方法对嘉兴市第一医院2009-2011年期间的结核病患者培养阳性菌株进行菌群鉴定及采用比例法对4种一线抗结核药物异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)进行药物敏感性测定,用SPSS17.0统计软件进行χ2检验,分析结果。结果本研究共纳入结核分枝杆菌277株,总耐药率为27.08%,耐多药率为11.19%;初治患者和复治患者耐药率分别为17.62%和56.72%,耐多药率6.19%和26.87%,两者差异均有统计学意义(χ2=4.96,P=0.026;χ2=21.85,P<0.01)。结论嘉兴市结核分枝杆菌的耐药情况依然严峻,尤其复治患者,在制定结核病防控策略时应给予充分重视,加强对复治肺结核患者高质量的全程监督短程化疗。
Objective To understand the drug resistance of Mycobacterium tuberculosis to first-line anti-tuberculosis drugs and to evaluate the drug resistance trend of tuberculosis in Jiaxing City in recent years. Methods The positive strains of TB patients in the First Hospital of Jiaxing from 2009 to 2011 were identified and the proportion of the four first-line anti-tuberculosis drugs, isoniazid (H), rifampicin (R), streptomycin (S), ethambutol (E) for drug susceptibility testing, χ2 test using SPSS17.0 statistical software, analysis of the results. Results A total of 277 Mycobacterium tuberculosis strains were enrolled in this study, with a total resistance rate of 27.08% and a resistance rate of 11.19%. The drug-resistant rates of newly diagnosed and re-treated patients were 17.62% and 56.72% 6.19% and 26.87%, respectively, with statistical significance (χ2 = 4.96, P = 0.026; χ2 = 21.85, P <0.01). Conclusion The drug resistance of Mycobacterium tuberculosis in Jiaxing City is still very serious. Especially in patients with retreatment, full attention should be paid to tuberculosis prevention and control strategies to strengthen high-quality full-time supervision of short-course chemotherapy in patients with retreatment tuberculosis.