2011-2012年东海县涂阳肺结核病人耐药监测结果分析

目的了解东海县结核分枝杆菌的耐药状况及其影响因素，为制订耐药结核的防治对策提供科学依据。方法收集2011--2012年全县痰涂片阳性患者的3份标本进行培养，用比例法进行6种抗结核药物（INH、RFP、EMB、S、Km和0fx）敏感性试验。结果2011—2012年涂阳患者350例，培养阳性283例（80．86％），经菌型鉴定及药物敏感性试验，结果缺失7例，非结核分枝杆菌17例，非耐药患者197例，耐药患者62例，总耐药率为23．94％；单耐异烟肼26例，单耐利福平2例，多耐药10例，其他耐药24例，耐药率分别为10．04％、0．77％、3．86％、9．27％。结论东海县结核分枝杆菌耐药率处于较高水平，耐药成因较为复杂，耐药谱呈多样性和复杂性，对结核病控制构成威胁，应进一步加强耐药结核病的监测和防治。

Analysis of results of drug resistance nmnitoring among smear positive pulmonary tuberculosis patients in Donghai County from 2011 to 2012

Objective To understand the status of drug resistance of mycobacterium tubereul（xsis （TB） and its influencing factors in I）onghai County, so as to provide the evidence for formulating the strategy of prevention and treatment of the drag-resistant riB. Methods The sputum smear-txsitive patients were recruited in current study in Donghai County from 2011 to 2012, and 3 specimens were collected from each patient. The sensitivity test was done of the collected specimens, and six kinds of anti-tuberculosis drugs （ INH, RFP, EMB, S, Km and Ofx） were compared. Results The total smear-positive patients were 350 from 2011 to 2012, and the cultivate-positive cases were 283 （80.86%）. There were 7 miing cases through the bacteria identification and drug sensitivity test. There was 17 cases of non-mycobacterium tuberculosis, 197 cases of non-resistant patients, 62 cases of drug resistance, and the total resistant rate was 23.94 % ; the single resistance cases of isoniazid were 26, rifampicin 2, and 10 cases were multiple drug-resistant and 24 cases were other drug resistance, and the resistance rates were 10.04%, 0.77%, 3. 86% and 0.77%, respectively. Conclusions The mycobacterium tuberculosis resistance rates are at higher level in Donghai Country, and the causes of drug resistance are relatively complex. The diversity and complexity were showed in the drug-resistant spectrum, which poses a serious threat to the TB control. Therefore, the monitoring, prevention and control of drug- resistant TB should be strengthening in the future.