初治培阳肺结核患者起始耐药情况分析

目的了解肺结核患者结核分枝杆菌起始耐药情况,制定科学的防治对策。方法采用世界卫生组织制定的结核分枝杆菌耐药监测方案进行结核分枝杆菌耐药监测。使用绝对浓度法对山东省胸科医院住院的1184例培阳肺结核患者的耐药性进行测定。结果 1184例培阳肺结核患者中,全敏感834例(70.44%),耐药350例(29.56%)。其中起始耐药157例(44.86%),复治耐药193例(55.14%)。在起始耐药病例中,单耐药结核病(MonoDR-TB)53例(33.8%),其中耐链霉素的病例最多(38例,24.2%);多耐药结核病(PDR-TB)72例(45.9%);耐多药结核病(MDR-TB)20例(12.7%);广泛耐药结核病(XDR-TB)12例(7.6%);无全耐药结核病(TDR-TB)患者。结论山东省胸科医院住院肺结核患者结核分枝杆菌起始耐药现状十分严重。实现抗结核防治方案的统一管理、全程督导化疗势在必行。

Initial Resistance of Mycobacterium tuberculosis in Patients with Culture Positive Pulmonary Tuberculosis

Objective To investigate the initial drug resistance of Mycobacterium tuberculosis（M.tuberculosis） in patients with culture positive pulmonary tuberculosis.Methods 1184 patients who hospitalized in Shandong Provincial Chest Hospital with culture positive pulmonary tuberculosis were enrolled.The absolute density method was used to assess the drug resistance of M.tuberculosis.Results M.tuberculosis were sensitive to all anti-tuberculosis drugs in 834 cases（70.44%）,and resistant in 350 cases（29.56%）,in which initial resistance and secondary resistance accounted for 44.86%（157/350） and 55.14%（193/350） respectively.In 157 cases with initial resistance,53 cases（33.8%） were mono-drug resistant tuberculosis（MonoDR-TB）,of which 38 cases were resistance to Streptomycin（24.2%）;72 cases（45.9%） were polydrug-resistant tuberculosis（PDR-TB）;20 cases（12.7%） were multidrug-resistant tuberculosis（MDR-TB）;12 cases（7.6%） were extensively drug resistant tuberculosis（XDR-TB）.There was no totally drug-resistant tuberculosis（TDR-TB）.Conclusions The initial drug resistance of M.tuberculosis in patients with pulmonary tuberculosis is still serious.Unified management of TB control programs and full supervision of chemotherapy are very imperative.