深圳市1999～2008年结核病细菌耐药性监测报告

目的掌握深圳市结核病的耐药状况及其连续变化趁势,评价结核病防治规划的实施效果,为改进结核病防治措施提供依据和参考。方法按世界卫生组织和国际防痨与肺部疾病联合会制定的“全球结核病耐药监测指南”的要求,采用“比例浓度法”,对1999年～2008年每年3～8月份登记的涂片阳性患者痰标本进行分离培养,对阳性的菌株进行菌型鉴定和异烟肼（H）、利福平（R）、乙胺丁醇（E）及链霉素（S）四种药物的敏感性测试。结果 1999年～2008年对6788例培养阳性的菌株进行菌型鉴定和药敏试验,其中非结核分枝杆菌86例、占1.3%;结核分枝杆菌6702例、占98.7%;连续监测10年的结核病耐药性,原发性耐药率从1999年的35.6%下降～2008年的14.9%、原发性耐多药率从1999年的5.4%下降～2008年的4.1%。四种抗结核药的耐药频率顺序由高至低依次为S、H、R、E。结论积极推行肺结核病归口管治,实施高质量的DOTS策略,肺结核病人在结防机构中得到较好管理和治疗,结核病耐药率呈下降趋势。

Report on the surveillance of drug-resistant resistant tuberculosis in Shenzhen,1999-2008

Objective To determine the status and trends in drug-resistant tuberculosis,to evaluate the implementation effect of tuberculosis control program,and to provide the reference and basis for tuberculosis prevention and control strategy.Methods According to WHO/IUATLD guidelines for anti-tuberculosis drug resistance surveillance,the proportional concentration method was adopted,all sputum culture positive patients registered from March to August per year from 1999 to 2008 was enrolled.Results 6788 patients had the results of identification and sensitivity during the study period.Of 6788 strains,6702（98.7%） M.tuberculosis and 86（1.3%） non-tuberculosis mycobacteria were identified.By the continuous surveillance from 1999 to 2008,the rates of primary drug-resistant and multidrugresistant tuberculosis were respectively decreased from 35.6% to 14.9% and from 5.4% to 4.1%.The drug-resistant frequency from high to low of the four TB drugs was S H〉 R〉 E.Conclusion By the centralized governance and high quality DOTS strategy,the tuberculosis patients are well managed and treated in the tuberculosis prevention and control institutions,and the rate of drug-resistant tuberculosis appear to be decreased in Shenzhen.