山东省耐药结核病流行状况研究

目的　建立以ＷＨＯ和国际防痨与肺部疾病协会（ＩＵＡＴＬＤ） 指南为基础的结核病细菌学耐药监测系统，掌握山东省起始和获得性耐药水平。方法　于１９９７ 年４ ～１０ 月应用整群抽样的方法在山东省的１４１ 个县（市）随机抽取３０ 个县（市）为监测点。各监测点连续选３６ 个新发涂阳肺结核病例，其间的复治涂阳病例同时纳入，并对全部培养阳性菌株进行菌型鉴定及４ 种抗结核药物（ＩＮＨ、ＳＭ、ＲＦＰ、ＥＭＢ） 的耐药性测试。结果　总耐药率为２３－４％ ，起始耐药率为１７－６％ ，起始耐多药率为２－９％ ，获得性耐药率为５０－０ ％ ， 获得性耐多药率为１９－６ ％ 。结论　山东省起始耐药仍处于较高水平，须进一步加强结核病控制规划。

Study on epidemic of drug resistant tuberculosis in Shandong province, China

Objective To establish the surveillance system for drug resistance of tuberculosis according to WHO and IUATLD guidelines, and to evaluate the initial and acquired drug resistance in Shandong province Methods 30 of 141 counties/cities were randomly selected as surveillance points by cluster sampling from April to October 1997, in each of which 36 cases with smear positive pulmonary tuberculosis were continuously observed Identification and susceptibility tests were done in all culture positive samples Results The total frequency of drug resistance was 23 4%, initial drug resistance 17 6%, initial multi drug resistance 2 9%, acquired drug resistance 50 0%, acquired multi drug resistance 19 6% Conclusions The results suggest that the initial drug resistance still ranks high in Shandong province, National TB Control Program should be further strengthened