廊坊市结核病耐药与主要流行特征分析

目的了解廊坊市结核分枝杆菌耐药情况及结核病主要流行特征,为耐药结核病的防治提供科学依据。方法将廊坊市2009-2013年确诊登记的痰涂片阳性肺结核患者作为研究对象,对涂阳患者痰标本进行结核分枝杆菌分离培养和菌型鉴定,采用比例法对一线抗结核药物（异烟肼、利福平、乙胺丁醇、链霉素）和二线抗结核药物（卡那霉素、氧氟沙星）进行耐药性检测。结果结核分枝杆菌的总耐药率为46.4%（819/1 764）,耐多药率为11.5%（203/1 764）,广泛耐药率为1.1%（20/1 764）;6种药物的耐药顺位依次是利福平、异烟肼、链霉素、乙胺丁醇、氧氟沙星、卡那霉素;复治患者的耐药率高于初治患者（χ^2=18.2,P〈0.05）;流动人口的耐药率高于本地人口（χ^2=14.3,P〈0.05）,差异均有统计学意义。结论廊坊市结核分枝杆菌的耐药率高于全国平均水平,复治患者和流动人口是结核病耐药高危人群,应根据特点采取有针对性的防治措施。

Tuberculosis drug resistance and major epidemiological characteristics analysis of Langfang city

Objective To understand the status of tuberculosis mycobacteria drug resistance and its major epidemiological characteristics of Langfang city,and provide scientific basis for tuberculosis prevention and control.Methods Sputum smear positive pulmonary tuberculosis patients who identified and registered in Langfang city during 2009-2013 were selected as objects,carried out tuberculosis mycobacteria isolated culture and identification,drug resistance test with first-line anti-tuberculosis drugs（ isoniazid,rifampicin,ethambutol,streptomycin） and second-line anti-tuberculosis drugs（ kanamycin,ofloxacin） were given through proportion method. Results Total drug resistance rate of mycobacterium tuberculosis was 46. 4 %（ 819 /1764）,multi drug resistance rate was 11. 5%（ 203 /1764）,widespread drug resistance rate was 1. 1%（ 20 /1764）;the resistance sequence of 6 drugs above-mentioned was rifampicin,isoniazid,streptomycin,ethambutol,ofloxacin and kanamycin in turn; drug resistance rate of retreatment patients was higher than initial treatment patients（ χ^2= 18. 2,P〈0. 05）,the drug resistance rate of floating population was higher than local residents（ χ^2= 14. 3,P〈0. 05）,all difference were statistically significant. Conclusions The drug resistance rate of tuberculosis mycobacterium in Langfang city was higher than national average,retreatment patients and floating population are high risk tuberculosis drug resistance population,prevention and control measures should be targeted adopt.