六安市某县结核病细菌学检测及耐药相关因素分析

目的 了解六安市某县结核病耐药状况及相关因素,为制订全市耐药结核病控制策略提供参考依据。 方法 随机抽取我市辖区1县(区),将2013年1月至12月所有登记肺结核病例作为研究对象,进行痰涂片镜检、细菌培养、药敏实验及菌种鉴定,并分析相关影响因素。 结果 结核分枝杆菌总耐药率(单耐药率)为25%(37/148),耐多药率为8.1%(12/148),广泛耐药率为2.03%(3/148);非结核分枝杆菌总耐药率(单耐药率)为100%(5/5) 耐多药率为80%(4/5),广泛耐药率为80%(4/5);单因素及多因素分析显示,复治是单耐药及耐多药结核病的危险因素,20～50岁年龄是耐多药结核病的独立危险因素。涂片阳性率为16.27%(95/584),痰培养阳性率为26.20%(153/584)。 结论 六安市某县结核病耐药疫情形势严峻,需加强对初治病例及青壮年病例的管理,提高其治疗依从性和治疗成功率,减少耐药结核发生。同时需加强结核病的细菌学检测工作,提高菌阳肺结核和耐药结核分枝杆菌的发现率。

Culture of mycobacterium tuberculosis and analysis of factors related to drug resistance in acounty of lu'an

Objective To explore the situation and related factors of drug resistance in tuberculosis (TB) patients in lu''an, and to provide evidence for the strategy developing of prevention and control of TB. Methods A county of lu''an was selected by random sampling, and all registered pulmonary TB patients from Jan 2013 to Dec 2013 were enrolled in the study, receiving such laboratory examinations as sputum smear, bacterial culture, drug sensitive test and strain identification. Univariate and multivariate analysis were performed on the related factors of drug resistance. Results A total of 148 TB patients infected with mycobacterium TB were included, and the total drug resistant rate, extensive resistant rate and multi-drug resistant rate of mycobacterium TB were 25% (37/148), 4.58% (3/148), 8.1%(12/148), respectively. On the other hand, the total drug resistant rate, extensive resistant rate and multi-drug resistant rate of non-mycobacterium TB were 100% (5/5), 80% (4/5) and 80% (4/5). Univariate and multivariate analysis showed that, receiving more than once TB treatment was risk factors of mono-resistant and multi drug resistant TB, and 20-50 years old was likely to be a independent risk factor of multi drug resistant TB. The smear positive rate was 16.27% (95/584), and the culture positive rate was 26.20% (153/584). Conclusion The high prevalence of drug resistance has been a major challenge for TB control in lu''an. To strengthen the control of untreated and young patients, as to increase the treatment compliance and treatment success rate, reduce the occurrence of drug resistance to TB, is critically important. Meanwhile, to intensify the bacteriology detection of TB is necessary, thereby increasing detective rate of drug resistance and culture positive pulmonary TB.