Drug resistance pattern of Mycobacterium tuberculosis isolates from patients of five provinces of Iran

Objective:To determine the patterns of resistance to first line anti-tuberculosis(TB)drugs among a collection of Mycobacterium tuberculosis(MTB)isolates from 5 provinces of Iran.Methods:A total of the 6 426 clinical specimens from patients suspected of active TB were collected from March 2010 to June 2012.All specimens were subjected for microscopy and culture tests in the TB centers of studies provinces.Drug susceptibility testing to the first line anti-TB drugs for culture positive MTB was performed on Lwenstein-Jensen(LJ)medium using proportion method.Results:Of 6 426 clinical specimens,261 were culture positive for mycobacteria,of which 252 were MTB and 9 were MOTT(mycobacteria other than tuberculosis).Of 252 MTB isolates.211(83.7%)were pan-susceptible and 41(16.3%)were resistant to at least one drug.Resistance was most common to streptomycin.30 isolates(12.0%),followed by isoniuzid,20isolates(8.0%),rifampin,15 isolates(6.0%)and ethambutol,14 isolates(5.5%).Sixteen(6.3%)MTB isolates were MDR.A clear evidence of heterogeneity amongst the 5 provinces in the proportions with resistance to one or more drugs was observed[χ~2=12.209(4 degrees of freedom),P values=0.015 9].Conclusions:The prevalence of drug resistance in this study area underscoring the need for further enforcement of TB control strategies in the Iran.Drug susceptibility testing for all TB cases to provide optimal treatment,establishing advanced diagnostic facilities for rapid detection of MDR-TB and continuous monitoring of drug resistance are recommended for prevention and control of drug-resistant TB.     

Analysis of the in vitro quinolones vesistance in Helicobacter pylori strains isolated in Zhejiang province

<正>Objective To investigate the in vitro quinolones resistance in Helicobacter pylori(HP)strains isolated in Zhejiang province and to provide references for the clinical application of quinolones in the eradication of HP infection.Methods A total of 713 HP strains were isolated from several hospitals located in different regions of Zhejiang province from April to June 2013.Drug sensitivity     

The effectiveness of individualized treatment regimen on smear-positive retreatment pulmonary tuberculosis with mono-and poly-drug resistance

正Objective To analyze and evaluate the effectiveness of individualized treatment regimen in the therapy of smear-positive retreatment pulmonary tuberculosis with mono-and poly-drug resistance,and therefore to provide information on how to develop rational individualized regimen for retreatment tuberculosis cases with drug resistance.Methods This was a multi-centered,prospective     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

2007年云南省克山病监测报告

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.     

湖北省结核分支杆菌耐药性监测研究

目的 建立以世界卫生组织（WHO）和国际防痨和肺病联合会（IUATLD）指南为基础的结核病耐药监测系统，掌握湖北省初始和获得性耐药水平，评价现行结核病控制策略效果。方法 采用整群抽样方法，在全省随机抽取30个县（市，区）为监测点，各监测点连续选30个新发涂阳肺结核病例，期间的其他涂阳病例同时纳入，并对全部培养阳性菌株进行菌型鉴定及SM，INH，RFP，EMB4种抗结核药物的药敏试验（比例法）。结果 共入选1136例，其中培养阳性1097例，培养阳性率为96．6％，污染率为0．4％。总耐药率为23．3％，其中初始耐药率为17．5％，获得性耐药率为44．5％，初始耐多药率（含H＋R）为2．1％。获得性耐多药率为21．8％。结论 初步建立了抗结核药物耐药性监测实验室方法和质量控制机制，首次获得可信的全省耐药水平资料。提示推行合理化疗和贯彻全程督导治疗原则对减少耐药的至关重要性和定期连续观测及深入研究的必要性。     

山东省耐药结核病流行状况研究

目的　建立以ＷＨＯ和国际防痨与肺部疾病协会（ＩＵＡＴＬＤ） 指南为基础的结核病细菌学耐药监测系统,掌握山东省起始和获得性耐药水平。方法　于１９９７ 年４ ～１０ 月应用整群抽样的方法在山东省的１４１ 个县（市）随机抽取３０ 个县（市）为监测点。各监测点连续选３６ 个新发涂阳肺结核病例,其间的复治涂阳病例同时纳入,并对全部培养阳性菌株进行菌型鉴定及４ 种抗结核药物（ＩＮＨ、ＳＭ、ＲＦＰ、ＥＭＢ） 的耐药性测试。结果　总耐药率为２３－４％ ,起始耐药率为１７－６％ ,起始耐多药率为２－９％ ,获得性耐药率为５０－０ ％ , 获得性耐多药率为１９－６ ％ 。结论　山东省起始耐药仍处于较高水平,须进一步加强结核病控制规划。     

甘肃省临夏州、甘南州、定西市结核病耐药监测结果分析

目的了解甘肃省临夏回族自治州、甘南藏族自治州、定西市结核分枝杆菌的耐药现状及耐多药情况,为甘肃省少数民族及贫困地区结核病防治提供科学依据。方法依据(WHO/ IUATLD)结核病耐药监测指南,将调查地区1年连续新发涂阳病人和同期新登记的复治涂阳病人作为监测病例,对成功分离的909例结核分枝杆菌菌株,用绝对浓度间接法进行药物敏感性实验。结果总耐药率26.0%,初始耐药率21.0%,获得性耐药率50.0%;耐多药率10.1%,其中初始耐多药率为7%,获得性耐多药率为24.1%;耐利福平菌株中有70.8%是耐多药（MDR-TB）菌株。结论甘肃省少数民族结核分枝杆菌的耐药的发生率较高,耐药现状应引起卫生主管部门及各级结核病防治机构的重视。     

河南省2010年结核病流行病学抽样调查点细菌学检测结果分析

目的 了解河南省人群中结核分枝杆菌的流行特征。 方法 依据《全国第五次结核病流行病学抽样调查实施细则》的抽样规则,抽取河南省36个点代表,共涉及18个地市的36个县,实检49 091名,均进行X线摄片检查,共发现肺结核可疑症状者和（或）X线胸片异常者2877例,收集此部分人群的痰标本,对痰标本进行涂片镜检、分离培养、菌株鉴定,以及一、二线抗结核药物（异烟肼、利福平、乙胺丁醇、链霉素、对氨基水杨酸、卡那霉素、氧氟沙星、丁胺卡那霉素、卷曲霉素）的耐药试验。 结果 在2877例可疑肺结核患者中发现痰涂片阳性者35例,涂阳率1.22%;分离培养的2875例中获得45株结核分枝杆菌,结核分枝杆菌阳性率为1.57%,其中北京基因型菌株占91.11%（41/45）,非北京基因型占8.89%（4/45）。肺结核患者任一耐药率和耐多药率分别为28.89%（13/45）、6.67%（3/45）。 结论 河南省结核分枝杆菌以北京基因型为主,仍为耐药结核病的高负担地区,需采取更加有效的防治策略和措施来控制结核病。     

2016年广东省涂阴培阳肺结核患者耐药情况分析

目的 了解广东省涂阴培阳肺结核患者的耐药情况。方法 收集广东省2016年1—12月32个结核病耐药监测点12323例临床确诊的初治涂阴肺结核患者作为研究对象,均进行了分枝杆菌培养检测,其中1224例阳性,涂阴培阳率为9.9%。经菌种鉴定,1177例(96.16%)为结核分枝杆菌复合群,47例(3.84%)为非结核分枝杆菌。对确定为结核分枝杆菌复合群的1177株菌株进行异烟肼(INH)、链霉素(Sm)、利福平(RFP)、乙胺丁醇(EMB)、卡那霉素(Km)、氧氟沙星(Ofx)、卷曲霉素(Cm)、丙硫异烟胺(Pto)、对氨基水杨酸(PAS)等9种药物的药物敏感性试验(简称“药敏试验”)。结果 12323例初治涂阴肺结核患者进行培养,涂阴培阳肺结核患者总耐药率为29.57%(348/1177),耐多药率为2.38%(28/1177),广泛耐药率为0.08%(1/1177),单耐药率为17.42%(205/1177),多耐药率为9.77%(115/1177)。男性耐多药率(2.94%,25/849)高于女性(0.91%,3/328),差异有统计学意义(χ ²=4.20,P=0.040)。多耐药谱有52种类型,其中耐INH+Sm者最多,占20.87%(24/115);其次为耐Sm+Km者(9.57%,11/115)。结论 广东省涂阴培阳肺结核患者有较高的耐药率,应加强监测与管理,减少耐药结核病的发生。     

黄石市结核病耐药性监测研究报告

目的　按照WHO IUATLD《结核病药物耐药性监测指南》结核病耐药监测技术系统 ,掌握黄石市初始和获得性耐药水平 ,评价结核病控制效果。方法 黄石市1999年新发现涂阳病例为本次研究对象。并对全部培养阳性菌株用比例法作H、R、E、S四种药物药敏试验。结果 共入选 2 10例 ,其中培养阳性 2 0 0例,培养阴性 8例 ,污染 2例。总耐药率 18.5 % ,初始耐药率 12 .5 % ,初始MDR -TB率 4 .4 % ;获得性耐药率 4 2 .5 %,获得性MDR TB率 2 0 .0 %。结论 黄石市结核病耐药流行状况处于国内外监测结果低水平。初步建立了WHO IUATLD结核病耐药性监测系统,获得了黄石市耐药水平资料 ,对评价现行结核病控制策略效果 ,改进防治措施具有重要的必要性和指导性。     

黑龙江省WHO结核病耐药监测报告

目的　掌握黑龙江省结核病细菌学耐药水平,评价结核病控制质量和效果,为制定全省结核病防治规划提供依据。方法 采用分层整群抽样,选取30个县(区)作为监测点,每个监测点痰涂片抗酸染色检查为阳性的病人均为入选病例,初治涂阳病人入选56例。采用比例法对INH、SM、RFP、EMB进行药物敏感性试验。结果 2004年耐药监测期间总纳入病例2144例,其中,痰培养污染率2.1%、涂阳培阴率3.8%,进行药敏试验人数2019例,供药敏分析1995例,初治病人占78.9%、复治病人占21.1%。初始耐药率为36.2%,获得性耐药率为67.7%,初始MDR耐药率为7.2%,获得性MDR耐药率为30.4%。结论 黑龙江省结核病耐药水平是已知开展耐药监测省份中高耐药省份之一,对黑龙江省结核病控制工作带来严重挑战。提示黑龙江省要一方面进一步提高全省DOTS的实施质量,通过做好基本DOTS来逐步减少耐药结核病人的产生;另一方面要积极争取解决现有耐药结核病人的治疗问题,最大限度地减少耐药结核病例,如期实现结防规划目标。     

马鞍山市结核病耐药性监测结果分析

目的了解马鞍山市结核病耐药流行情况及影响因素,为耐药结核病的预防和控制提供依据。方法按照全国结核病耐药性监测实施方案要求,对马鞍山市2013年所有新登记的肺结核患者进行痰培养,并对培养阳性菌株进行菌种鉴定和一、二线抗结核药物敏感试验。结果 2013年新登记肺结核患者481人,培阳并可纳入耐药分析127人,总耐药率和耐多药率分别为37.80%和9.45%,其中初始总耐药率和耐多药率为32.00%和5.00%,获得性总耐药率和耐多药率为59.26%和25.93%。结论马鞍山市结核病耐药疫情较为严峻,今后需进一步加强耐药结核病的防治工作。     

浙江、广东省耐药监测项目中耐药肺结核治疗现况研究

目的　探讨耐药监测项目中初始耐药与获得性耐药肺结核病人的耐药情况与在完成规范短程化疗方案时的治疗效果,为初始与获得性耐药肺结核病人的管理与治疗提供参考依据。方法 对浙江和广东两省纳入结核病耐药性监测项目的肺结核病患者以比例法测定耐药情况并在短程督导化疗下观察耐药肺结核病人的治疗结果。分析完成规范短程化疗方案的耐药肺结核病人225例的耐药与治疗情况。结果 初始耐药肺结核病人149例,其中耐单药87例,耐多药62例;获得性耐药肺结核病人76例,其中耐单药者38例,耐多药38例。初始耐单药肺结核病人治愈率94.3%;耐多药肺结核病人治愈率88.7%;获得性耐单药肺结核病人治愈率92.1%,耐多药肺结核病人治愈率63.2%。结论 对耐单药的肺结核病人继续应用原规范短程化疗方案,仍可获得较好的治疗效果,而耐多药肺结核病人特别是获得性耐多药肺结核病人的治疗效果较差。对耐药肺结核病人,应结合胸部X片检查以及结核菌培养等综合判断疗效。建议组织开展全国性的肺结核病耐药性的基线调查;开展耐药结核病,特别是耐多药结核病治疗的进一步研究,组织对耐多药结核病治疗的试点;加强结核病痰细菌学检查和药物敏感性试验的质量控制。     

河南省第二轮结核病耐药监测及耐药趋势研究

目的掌握河南省2001年结核病耐药水平,评价1996—2001年耐药趋势,为结核病控制决策提供参考。方法采用整群抽样随机抽取30个监测点,各监测点连续入选43个新涂阳病人,同时纳入其间的复治涂阳病例。痰涂片镜检采用Ziehl-Neelsen法,培养用L-J培养基。对培养阳性的菌株用TCH和PNB进行菌型鉴定。对四种抗结核药物:INH,RFP,EMB和SM采用比例法进行药敏试验。结果总耐药率、初始耐药率及获得性耐药率分别为35.3%,29.8%和60.8%;总MDR率、初始MDR率和获得性MDR率分别为:12.9%,7.8%和36.6%。2001年河南省总耐药率、初始耐药率及总MDR率、初始MDR率较之1996年有所下降,但获得性耐药率及获得性MDR率变化不明显。结论河南省结核病耐药率仍处于全国5个监测省份之首和全球前几位,应引起高度重视。同时提示河南省需采取得力措施落实DOTS策略。