2012-2015年长沙地区肺结核患者结核分枝杆菌耐药状况分析

摘要:目的 了解长沙地区结核分枝杆菌耐药情况。方法 分析某院2012年1月至2015年10月分离的6 198株结核分枝杆菌对9种抗结核药物的耐药情况。结果 6 198株结核分枝杆菌复合群菌株耐药率顺位前5位依次为INH(14.18％)、RFP(13.57%)、SM(12.31％)、EMB(3.87%)、OFLX(2.60%)；总耐药率为20.56%，耐多药占9.31%，多耐药占4.52%，广泛耐药占0.45%；除2012年20岁以下年龄组女性耐药结核菌的检出率略高于男性外，其余年份各年龄组男性均高于女性；复治患者的耐药率(24.76%)高于初治患者(19.49%)，两者差异有统计学意义(χ2=176.21，P<0.001）；结论 院结核分枝杆菌耐药率总体低于全国第五次结核病流行病学调查结果，但耐多药率高于全国水平，耐药状况仍然严峻。

Drug resistance analysis on Mycobacterium tuberculosis in patients with pulmonary tuberculosis in Changsha area during 2012~2015

Abstract: Objective This work was to investigate the current situation of Mycobacterium tuberculosis (MTB) drug resistance in Changsha Central Hospital. Methods Totally 6198 MTB strains were identified in Changsha Central Hospital from 2011 to 2015 and the sensitivity of MTB strains to 9 kinds of anti-tuberculosis drugs was performed. Results The top 5 of the drug resistance rates of 6198 strains of MTB complex group were INH(14.18％), RFP(13.57%), SM(12.31％), EMB(3.87), OFLX(2.60). The overall resistance rate to anti-TB drugs was 20.56%. MDR rate was 9.31%. PDR rate was 4.52% and XDR rate was 0.45%. The MTB detection rate was higher for males in each age group except that in 2012 in the group of under 20 years old females showed higher MTB detection rate. The resistance rates among retreated patients were higher than that among initial patients. Conclusion Compared to the results of the fifth national tuberculosis epidemiological survey, the prevalence of MTB　drug resistance in our hospital was lower, but MDR rate higher. Therefore, the situation of MTB drug resistance is still serious.