实施DOTS策略后合肥市结核病人耐药性分析

目的 了解合肥市实施DOTS策略后肺结核病例的耐药状况,为制定控制耐药结核病提供科学依据.方法 对合肥市疾病预防控制中心结核病门诊2009年2月～2010年1月392例培养阳性病例进行菌型鉴定,获得352例结核分枝杆菌并对其进行异烟肼、利福平、链霉素、乙胺丁醇等药物敏感性鉴定.结果 352例结核分枝杆菌中总耐药率及耐多药率分别是20.5％和3.1％.初始耐药率为16.3％,初始耐多药率为1.9％；其获得性耐药率为52.5％,获得性耐多药率为12.5％.复治病人的耐药率明显高于新病人；耐药率最高的是SM 25％.结论 合肥市总耐药率和耐多药率低于全国耐药基线调查结果,但控制结核分枝杆菌耐药形势刻不容缓,今后要加强对新发男性青壮年病人的管理措施,提高病例的依从性和治愈率.

Analysis of drug resistance of patients with tuberculosis after implemention of DOTS strategy in Hefei city

OBJECTIVE To get the drug resistance situation of TB cases after implemention of DOTS strategy in Hefei,to provide scientific bases to control drug-resistant tuberculosis.METHODS The identification of mycobacterium for 392 positive cases during Feb.2009 to Jan.2010 in Tuberculosis Clinic of Hefei CDC,we got 352 cases of mycobacterium tuberculosis and did drug sensitivity identification,such as isoniazide,rifampicin,streptomycin,ethambutol,and so on.RESULTS The total drug resistance rate in 352 cases of mycobacterium tuberculosis was 20.5%,the total MDR rate was 3.1%.The initial drug resistance was 16.3%(51/312),and the initial MDR rate was 1.9%(6/312),the acquired drug resistance rate was 52.5%(21/40),and the acquired MDR rate was 12.5%(5/40).The drug resistance rate of re-treated patients was significantly higher than new ones.The highest of the drug resistance rate was SM 25%.CONCLUSION The total MDR rate of Hefei City is significantly lower than the national tuberculosis resistance baseline,so the control of mycobacterium tuberculosis resistance is no time to delay.From now on,strengthen management measures for new males youths patients,enhance the compliance and cure rate of cases.