2014年长沙市155株耐多药结核分枝杆菌耐药结果分析

目的 分析长沙耐多药结核分枝杆菌(MDR-TB)菌株对抗结核药物的敏感性,为防治耐多药结核病提供科学依据。 方法 采用绝对浓度间接法检测2014年长沙市155株耐多药结核分枝杆菌临床分离株对一二线抗结核药物的耐药性,回顾性分析其耐药情况。 结果 155例耐多药结核分枝杆菌分离株对一二线抗结核药物耐药率从高到低为:链霉素(S)＞乙胺丁醇(E)＞左氧氟沙星(OFL)＞ 对氨基水杨酸钠(PAS)＞丙硫异酰胺(TH)＞卡那霉素(K)= 吡嗪酰胺(PZA),耐药率依次为:70.32%、36.13%、20.65%、12.90%、8.39%、3.87％、3.87%。耐两种药的耐药株达46株,其中以链霉素与乙胺丁醇为主,其耐药率达29.68%;耐三种药的耐药株达18株,其中以链霉素、乙胺丁醇与左氧氟沙星为主,其耐药率达11.61%;耐四种药的耐药株有5株,其中以链霉素、乙胺丁醇、左氧氟沙星及丙硫异酰胺为主,耐药率为3.23%;耐五种药和六种药的各有1株和2株。 结论 2014年长沙市MDR-TB对一线甚至二线抗结核药耐药严重,为MDR-TB防治带来巨大挑战。

Drug resistance of 155 strains of multi-drug resistantMycobacterium tuberculosis in Changsha, 2014

Objective To analyze the sensitivity of multi-drug resistant (MDR) Mycobacterium tuberculosis isolates in Changsha to antituberculosis drugs, so as to provide evidence for the treatment of multi-drug resistant tuberculosis(MDR-TB). Methods The absolute concentration indirect method was used to test the drug resistance of 155 clinical isolates of Mycobacterium tuberculosis to first-line and second-line antituberculosis drugs. Their drug resistance was retrospectively analyzed. Results The first-line and second-line antituberculosis drugs withdrug resistance rates in descending order in the 155 clinical isolates of Mycobacterium tuberculosis were as follows: streptomycin,ethambutol, levofloxacin,p-aminosalicylic acid,cethionamide,amikacin and pyrazinamide. Their drug resistance rates were 70.32%, 36.13%, 20.65%, 12.90%, 8.39% , 3.87％ and 3.87％ in turn. 46 strains were detected to be resistant to two drugs, mainly streptomycin and ethambutol, with the drug resistance rate of 29.68%. 18 strains were resistant to three drugs, mainly streptomycin, ethambutol and levofloxacin, with the drug resistance rate of 11.61%. 5 strains were resistant to four drugs, mainly streptomycin, ethambutol, levofloxacin and cethionamide, with the drug resistance rate of 3.23%. One isolate was resistant to five drugs and two to six. Conclusions The resistance of multi-drug resistant tuberculosis to first-line and second-line antituberculosis drugs is serious in Changsha in 2014,which brings great challenge to the cure of multi-drug tuberculosis patients.