复治肺结核患者耐药谱分析

目的 了解复治肺结核患者结核分枝杆菌耐药谱特点,为结核病的防治提供依据.方法 将该院2009年11月至2010年11月的痰涂片标本抗酸菌检测阳性的肺结核复治患者作为监测对象,对107例成功分离的结核分枝杆菌菌株用比例法进行药物敏感试验.结果 总耐药率43.9%,耐多药率28.9%,耐单药率14.9%.对链霉素(S)、异烟肼(H)、利福平(R)和乙胺丁醇(E) 4种药物的耐药率分别为23.4%(25/107)、32.7%(35/107)、32.7%(35/107)和13.1%(14/107),其中单药耐药频率以耐H或R最高.耐药患者中以耐HSR和耐HSRE为主,各占8.4%.不同性别耐药率差异无统计学意义(P＞0.05).结论 复治肺结核患者耐药率仍处在较高水平,对耐药结核病的临床治疗和管理应给予足够的重视.

Analysis of drug resistance pattern in retreatment patients with pulmonary tuberculosis

Objective To investigate the drug resistance pattern of Mycobacterium tuberculosis isolated from retreatment patients with pulmonary tuberculosis and provide scientific evidence for tuberculosis control.Methods Registered sputum smear-positive retreatment patients with pulmonary tuberculosis,tested by acid-fast bacteria staining from Nov.2009 to Nov.2010,were enrolled.A total of 107 strains of Mycobacterium tuberculosis were isolated and drug susceptibility test were performed with the proportional method.Results The overall drug resistance rate,multi-drug resistance rate and single-drug resistance rate were 43.9%,28.9% and 14.9% respectively.Resistance rates were respectively 23.4%(25/107),32.7%(35/107),32.7%(35/107) and 13.1%(14/107) to streptomycin(S),isoniazid(H),rifampicin(R) and ethambutol(E).The highest frequency of single-drug resistance was H or R resistance.Among patients with drug resistance,the highest frequency was resistance to HRS and HRES,accounting for 8.4% for each.Drug resistance rates were not statistically different between genders.Conclusion The incidence of drug resistance in retreatment patients with pulmonary tuberculosis might be still high,and the management and clinical treatment for tuberculosis patients should be emphasized.