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中国防痨杂志 ›› 2005, Vol. 27 ›› Issue (4): 247-250.

• 论著 • 上一篇    下一篇

1994—2003年广州老城区门诊病人耐药结核病流行状况分析

罗一鲁；刘志辉；罗春明；   

  1. 广东省广州市胸科医院 广州 510095；
  • 出版日期:2005-04-10 发布日期:2005-11-03

Analysis on situation of drug-resistant tuberculosis among outpatients in primary urban districts of Guangzhou from 1994-2003

Luo Yilu, Liu Zhihui, Luo Chunming.   

  1. Guangzhou Chest Hospital, Guangzhou 510095,Chin
  • Online:2005-04-10 Published:2005-11-03

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摘要： 目的　分析广州市老城区10年耐药结核病的流行状况和流行趋势,为今后结核病控制的有效开展提供决策依据。方法 回顾性分析结核病肺部肿瘤防治所1994—2003年结核杆菌耐药性测定资料。结果 10年间,9044株临床分离结核菌株的总耐药率、初始和获得性耐药率分别为23.7%、20.7%和34.6%,总耐药率、初始耐药率呈总体缓慢下降趋势,获得性耐药率反之;2145株耐药株的耐药顺位为:H(20.3%)、R(10.2%)、S(9.5%)、E(5.0%),其中初始耐药率顺位为:H(17.7%)、R(8.3%)、S(8.1%)、E(4.1%),获得性耐药率顺位为:H(29.8%)、R(16.7%)、S(14.3%)、E(8.3%),耐单药、耐二药、耐多药率分别为:10.8%、3.4%和9.0%,其中其初始耐药率分别为:9.8%、3.0%和7.6%,获得性耐药率分别为:14.4%4、.6%和14.0%,10年间获得性耐H、R、S率及获得性耐多药率呈总体上升趋势,初始耐单药率则呈总体下降趋势。结论 耐H和R菌株率和初始耐多药率的居高不下、获得性耐药率与获得性耐多药率的上升趋势、初始耐单药率总体下降趋势表明未来结核分枝杆菌耐药性发生更趋向于耐多种药物,必须采取积极有力的措施,控制耐药结核病尤其是耐多药结核病的流行与蔓延。

关键词: 分枝杆菌,结核, 药物耐受性, 流行病学

Abstract: Objective To analyze current situation and trend of drug-resistant tuberculosis in primary urban districts of Guangzhou during the recent ten years and provide the evidences for TB control policy makers in Guangzhou. MethodsTesting records of tuberculosis drug susceptibility test from laboratory department of TB and Pulmonary Tumor Control Institute were analyzed retrospectively during the period 1994-2003. Analyzed anti-TB drugs included isoniazid (H), rifampin ?, streptomycin (S) and ethambutol (E). ResultsThe total, initial and acquired drug resistance rate of 9044 strains of Mycobacterium tuberculosis from clinical isolation were 23.7%, 20.7% and 34.6% respectively. The total and initial drug resistance rate presented slowly descended trend, and the acquired drug resistance rate was on the contrary during the ten years. The order of drug resistance of 2145 drug resistance strains according to from high level to low level was H (20.3%), R (10.2%), S (9.5%) and E (5.0%).The order of initial drug resistance rate was H (17.7%), R (8.3%), S (8.1%) and E (4.1%), and that of acquired resistance rate was H (29.8%), R (16.7%), S (14.3%) and E (8.3%). The drug resistant rates of single drug, 2 drugs and multi-drugs were 10.8%, 3.4% and 9.0% respectively. Their initial drug resistance rates were 9.8%, 3.0% and 7.6%, and their acquired resistance rates were 14.4%, 4.6% and 14.0%. Their acquired resistance rates of H, R, S and multi-drugs showed generally rising trend while the initial drug resistance rate was a decreasing trend during the ten years. ConclusionsAccording to the above results, we should pay great attention to high level of drug resistance rate of H, R and the initial drug resistance rate, generally rising trend of the acquired resistance rates and acquired multi-drugs resistance rates and a decreasing trend of the initial drug resistance rate that predicts producing more Mycobacterium tuberculosis strains of multi-drugs resistance in a specific number of strains in future. We must take initiative in TB control to prevent the prevalence and spread of drug resistance tuberculosis, especially of multi-drugs resistance tuberculosis.

Key words: Mycobacterium tuberculosis, Drug resistance, Epidemiology

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