279株结核分枝杆菌耐药情况分析

目的：了解目前云南省结核病耐药情况，为临床治疗及制定策略提供依据．方法采用世界卫生组织推荐的比例法对临床分离的结核分枝杆菌菌株进行INH、RFP、EMB、SM 4种一线抗结核药物的药敏试验．结果301株分枝杆菌分离株中279株（92.7%）为结核杆菌复合群，结核分枝杆菌的总体耐药率为31.5%（88/279），其中初始耐药率为27.3%，获得性耐药率为44.3%；结核杆菌对INH、RFP、EMB和SM的耐药率分别为19.7%、10.8%、12.9%和19.0%，耐多药率为9.3%．总体耐药情况与云南省既往数据以及全国水平基本持平．结论结核病控制工作任重道远．应及早发现耐药结核病患者并给予规律治疗，同时应把耐药趋势的追踪和耐药监测作为结核病防治规划的重要组成部分并定期观察．

Analysis on Resistance Status of 279 Strains of Mycobacterium tuberculosis

Objective The purpose of the study was to understand the resistance status of to anti-tuberculosis drug in Yunnan province, and to provide evidence for tuberculosis （TB） control. Methods The proportional method was used in drug sensitivity test according to the guidelines recommending by WHO. Results Of 301 mycobacterial isolates, 279 （92.7%） strains were complex （MTBC） . The total drug resistance rate was 31.5% （88/279）,the initial drug resistance rate of was 27.3%, and the acquired drug resistance rate was 44.3%. The drug resistance rates to INH,RFP,EMB and SM were 19.7%, 10.8%, 12.9%and 19.0%, respectively. The multi-drug resistance （MDR） rate was 9.3%. Conclusion The drug resistant rate of is still high in Yunnan province,and TB control is still a long way to go. Early detection and regular treatment should be done for MDR patients. Drug resistance monitoring as an important part of TB control programs should be regular observation and research.