南宁市耐多药肺结核患者的发现和接受治疗情况

目的 分析南宁市2012—2016 年耐多药肺结核患者发现和纳入治疗情况,为政府制定针对性的耐多药肺结核防治策略提供参考依据。方法 收集南宁市自2012年5月—2016年12月耐多药肺结核可疑者的培养、药敏及接受治疗和转归等资料,分析不同登记分类、不同年份耐多药肺结核可疑者的涂阳培阳率、耐多药肺结核检出率以及耐多药肺结核患者的接受治疗比例。结果 自2012年5月—2016年12月,南宁市共登记耐多药肺结核可疑者7 987例,开展痰结核分枝杆菌培养2 844例,痰培养阳性1 946例,痰培养阳性率为68.42%;开展传统药敏试验1 900例,经菌种鉴定结核分枝杆菌复合群1 820例,检出耐多药肺结核213例,耐多药肺结核检出率为11.70%;确诊的213例耐多药肺结核患者中,纳入治疗管理106例,纳入治疗率为49.77%,接受治疗的患者中,治愈40例,完成疗程18 例,治疗成功率为54.72%。结论 2012—2016年南宁市耐多药肺结核防治取得一定效果,但耐多药肺结核检出率较低也可能与涂阳培阳率低导致检出例数减少有关。针对纳入治疗率和治疗成功率相对较低的问题,建议要提高耐多药肺结核患者的治疗管理水平,不断探索改进耐多药肺结核防控策略从而达到降低耐多药肺结核疫情的目的。

Case detection and treatment with multidrug-resistant tuberculosis in Nanning

Objective To provide a reference for the government to develop a targeted MDR-TB prevention strategy by analyzing the findings and treatment of patients with multidrug-resistant pulmonary tuberculosis in Nanning from 2012 to 2016. Methods Data of cultivation, drug sensitivity, treatment and prognosis of suspected MDR-TB patients in our city from May 2012 to December 2016 were collected from TB management information system of CDC.The positive smear rate, detection rate and treatment rate of patients with suspected MDR-TB in different registration categories and different years were analyzed. Results From May 2012 to December 2016, 7 987 suspected cases of MDR-TB were registered; 2 844 cases were cultured for Mycobacterium tuberculosis in sputum, of which 1 946 cases were positive for sputum culture, and the positive rate for sputum culture was 68.42%; 1 900 cases were tested for traditional drug sensitivity test, 1 820 cases were identified for Mycobacterium tuberculosis complex, 213 cases were detected for MDR-TB and 11.70% for MDR-TB. Of the 213 patients diagnosed as MDR-TB, 106 were included in the treatment management, with a treatment rate of 49.77%. Among the patients treated, 40 were cured and 18 completed the course of treatment, with a success rate of 54.72%. Conclusion The prevention and treatment of MDR-TB in Nanning City from 2012 to 2016 have achieved certain results, but the low detection rate of MDR-TB may also be related to the decrease of detection cases due to the low rate of smear positive cultivation. In view of the relatively low inclusion rate and success rate of treatment, it is suggested that the treatment and management level of MDR-TB patients should be improved, and the prevention and control strategies of MDR-TB should be continuously explored so as to reduce the epidemic situation of MDR-TB.