深圳市2016—2018年耐利福平结核病中耐多药结核病分布特征

目的 掌握深圳市耐利福平结核病中耐多药结核病检出情况及其分布特征,为制定耐药结核病临床治疗及预防控制措施提供理论依据。方法 收集2016—2018年在中国疾病预防控制信息系统《结核病信息管理系统》登记报告的深圳市耐药可疑肺结核患者信息资料,对耐利福平肺结核及其中的耐多药肺结核病检出情况、分布特征进行分析。结果 2016—2018年报告耐药可疑肺结核病7 669例,检出耐利福平肺结核病664例,检出率为8.7%。其中耐多药肺结核病506例（占76.2%）;2016—2018年耐利福平肺结核病检出率分别为8.5%、9.1%、8.3%,差异无统计学意义(P>0.05);耐多药肺结核病检出率分别为6.3%、7.5%、6.0 %,差异无统计学意义(P>0.05)。2016—2018年共报告耐利福平肺结核病男性检出率为8.7%,女性为8.6%,差异无统计学意义(P>0.05);耐多药肺结核病男性检出率为6.3%,女性为7.2%,差异无统计学意义(P>0.05)。职业分类为教师、学生、农民、民工、餐饮食品业的耐利福平结核病患者中耐多药结核病患者占100.0%,登记分类为返回的耐利福平结核病患者中耐多药结核病患者占100.0%。结论 深圳市耐利福平肺结核病中耐多药结核病检出率较高,在师生、农民工及返回类耐利福平结核病患者中表现最为明显,建议对该类耐利福平结核病患者的治疗尽早采取强化方案,提高师生及农民工患者管治质量,避免服药中断,降低耐药肺结核病发生。

Distribution characteristics of multidrug-resistant tuberculosis among rifampicin-resistant tuberculosis patients in Shenzhen, 2016-2018

Objective To identify the detection and distribution characteristics of multidrug-resistant tuberculosis among rifampicin-resistant tuberculosis patients in Shenzhen. It provides a theoretical basis for the formulation of clinical treatment and prevention strategy for drug-resistant tuberculosis. Methods To collect the information material of registered drug-resistant suspected TB patients reported by China's disease prevention and control information system from 2016 to 2018, and analyze the detection and distribution characteristics of multidrug-resistant TB among rifampicin-resistant TB patients by using Chi-square test to compare the difference in rates. Results Totally 7 669 cases of drug-resistant suspected TB were reported in Shenzhen from 2016 to 2018, 664 cases were found to be rifampicin-resistant TB(The detection ratio was 8.7%), among them, 506 cases were multidrug-resistant TB which accounted for 76.2%. From 2016 to 2018, the detection rates of rifampicin-resistant TB were 8.5%, 9.1% and 8.3%, and there were no significant differences among them (P>0.05).The detection rates of multidrug-resistant TB were 6.3%, 7.5% and 6.0%, and there were no significant differences among them either(P>0.05).There were 8.7% male and 8.6% female with rifampicin-resistant TB respectively, with no statistically significant differences (P>0.05). There were 6.3% male and 7.2% female with multidrug-resistant TB, and there were no significant differences (P>0.05). Multidrug-resistant TB patients in the occupational classification of teachers, students, farmers, migrant workers, food and beverage industry accounted for 100.0% of rifampicin-resistant TB patients. The returning multidrug-resistant patients also accounted for 100.0%. Conclusion There was a high detection rate of multidrug-resistant TB among rifampicin-resistant TB patients in Shenzhen. Teachers, students, migrant workers and returning patients were the most obvious ones. Therefore, it was recommended to use early intensified treatment on rifampicin-resistant TB patients, improve the management quality for teachers, students and migrant workers, avoid treatment interruptions,and eventually reduce the incidence of drug-resistant TB.