上海市奉贤区结核杆菌耐药性分析

目的 ]　了解初治和复治肺结核病人对抗结核化学药物的敏感性。　 方法 ]　收集 2 0 0 2年 1月至 2 0 0 3年7月痰菌阳性标本 ,用改良罗氏培养基绝对浓度法试验 ,最终获取培养阳性标本 2 14份 ,对全部培养阳性标本进行 5种抗结核药物 (SM、INH、PAS、EMB、RFP)的耐药性测定。　 结果 ]　总耐药率为 3 9.2 5 % ( 84/2 14 ) ;初始耐药率为 11.83 %( 11/93 ) ,初始耐多药率为 7.5 3 % ( 7/93 ) ;获得性耐药率为 60 .3 3 % ( 73 /12 1) ,耐多药率为 47.93 % ( 5 8/12 1)。对抗结核药物的耐受 ,主要是耐受SM ( 75 .0 0 % ,63 /84)和INH( 63 .10 % ,5 3 /84)。　 结论 ]　获得性耐药率高于初始耐药率 ,应进一步加强对结核杆菌药物敏感性监测。

Analysis on drug resistance of mycobacterium tuberculosis in Fengxian district Shanghai

To understand primary and acquired drug resistance of mycobacterium tuberculosis. M.tuberculosis positive sputum samples were collected from January 2002 to July 2003. Ameliorative Lowenstein-Jensen' culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis. 214 samples were affirmed. Drug susceptibility test against streptomycin(SM), isoniazid (INH),rifampicin (RFP), ethambutol (EMB) and sodium para-aminosalicylate (PAS) were tested. The total drug resistance rate was 39.25% (84/214), the initial drug resistance rate was 11.83% (11/93), the initial multi-drug resistance rate was 7.53% (7/93), the acquired and multi-drug resistance(MDR) rate were 60.33% (73/121) .MDR-TB rate was 49.93% (58/121). SM and INH were primary and secondary resistance drugs, the rates were 75.00% (63/84) and 63.10% (53/84). Conclusion] The acquired drug resistant and multi-drug resistant rates were higher than the initial drug resistance rate. Drug sensitivity surveillance on mycobacteria tuberculous should be further strengthened.