青海省利福平耐药/耐多药肺结核流行特征分析

目的 掌握青海省利福平耐药结核病检出情况和耐多药结核病分布情况,为利福平耐药结核病防控提供理论依据.方法 收集青海省2016-2019年最终鉴定为结核分枝杆菌的1 182株菌株,采用比例法对4种一线及2种二线常用抗结核药品(异烟肼、利福平、乙胺丁醇、链霉素、卡那霉素、氧氟沙星)进行药物敏感性试验,并对上述菌株的利福平耐...

Epidemiological characteristics of rifampicin-resistant and multidrug-resistant tuberculosis in Qinghai

  Objective  To understand the detection of rifampicin-resistant tuberculosis (RR-TB) and the distribution of multidrug-resistant tuberculosis (MDR-TB) in Qinghai province and provide theoretical evidence for the prevention and control of RR-TB.   Methods  The tuberculosis reference laboratory of Qinghai Provincial Center for Disease Control and Prevention used the proportional method to test the drug susceptibility of 1182 Mycobacterium tuberculosis strains collected from 8 cities in Qinghai from 2016 to 2019 to four commonly used first-line and two second-line anti-TB drugs (isoniazid, rifampicin, ethambutol, streptomycin, kanamycin, ofloxacin). The results of rifampicin-resistance detection and MDR-TB prevalence were analyzed.   Results  The overall rifampicin-resistant rate of 1182 M. tuberculosis strains was 11.42%, and the overall multidrug-resistant rate was 8.80%. The MDR-TB cases accounted for 77.04% of RR-TB cases. The differences in rifampicin-resistant rate and multidrug-resistant rate in different years were significant (χ2=373.672, 225.453, P＜0.05). The rifampicin-resistant rate and multidrug-resistant rate were higher in retreated cases than in initial treated cases, and the difference was significant (χ2=130.865, 99.943, P＜0.05). There were statistically significant differences in rifampicin-resistant and multidrug-resistant rate between men and women (χ2=130.779, 99.888, P＜0.05), among different age groups (χ2=342.791, 163.139, P＜0.05), ethnic groups (χ2=130.993, 100.003, P＜0.05) and occupation groups (χ2=253.844, 186.207, P＜0.05).   Conclusion  The rifampicin-resistant rate in TB cases in Qinghai was high, and multi-drug resistance was also common. Therefore, the surveillance and treatment of drug–resistant TB should be strengthened, especially in men, young and middle-aged people, ethnic minorities, farmers and herdsmen and other key groups.