泉州市肺结核病人结核杆菌耐药性动态观察

目的评价泉州市结核杆菌的耐药动态。方法收集本所自1990~2004年15年来门诊及住院肺结核病例的菌株做药敏试验。每三年为一分析阶段共五个阶段进行耐药率分析。结果初治耐药率分别为27.8%,22.7%,22.1%,17.3%和9.6%;初治耐多药率分别为2.5%,3.6%,6.5%,2.7%和3.0%。复治耐药率分别为66.7%,71.7%,65.6%,58.2%和60.6%;复治耐多药率分别为25.5%,31.3%,25%,24.6%和27.0%。初治耐药率随年度阶段呈逐渐下降趋势;但复治耐药率下降不明显,并且复治耐多药率远远高于初治耐多药率。结论控制耐药的关键是早发现,早治疗,采用DOTS策略彻底治愈传染性肺结核,并做好耐药监测评价工作。

Dynamic observation of drug resistance for tuberculosis in Quanzhou

Objective To analyze and evaluate the trend of antituberculosis drugs resistance for tuberculosis and provide base for tuberculosis control. Methods The data of in-patients and out-patients during the years of 1990-2004 were collected. The trend of drug resistance was analyzed. Results The prevalence of primary drug resistance was 27.8%, 22.7%, 22. 1%, 17. 3% and 9.6% in five periods of 1990-1992, 1993-1995, 1996-1998, 1999-2001 and 2002-2004 respectively. The prevalence of primary MDR--TBdrug resistance was 2.5%, 3.6.%, 6.5%, 2. 7% and 3%, respectively for the periods. The prevalence of acquired drug resistance was 66. 7%, 71. 7%, 65. 5%, 58. 2% and 60. 6%, respectively for the periods. The prevalence of acquired MDR-TB drug resistance was 25.5%, 31.3%, 25%, 24.6% and 27.0%, respectively for the periods. The prevalence of primary drug resistance was decreasing and the prevalence of acquird MDR-TB drug resistance was decreasing slightly. Conclusion The keys of controlling drug resistance are early diagnose and treatment of prevention spreading of pulmonary tuberculosis, implementation of DOTS and improvement of the evaluation work of drug resistance.