关键词: 结核,肺, 药物耐受性, 监测

Abstract: Objective To understand the developing status and tendency of drug resistant tuberculosis in Zhejiang,and to evaluate the effect of ongoing DOTS strategy. Methods The Guidelines for Surveillance of Drug Resistance in Tuberculosis of WHO/IUATLD were followed in registration smear positive TB and comparing the result of surveillance for tuberculosis bacteria drug resistance with the Results of the first drug resistance surveillance in 1998/1999. Results 1 127 TB patients were enrolled in 30 counties.Drug susceptibility testing against streptomycin(S),isoniazid(H),rifampicin(R) and ethambutol(E) were performed in 988 cases.The total drug resistance rate was 30.6%,the initial drug resistant rate was 26.6%,the initial multi-drug resistance was 3.7%,the acquired drug and multi-drug resistant rates were 51.9% and 29.2%,respectively.Among the new cases with drug resistant tuberculosis,65.8% of the cases showed resistance to single drug.The order of initial drug resistance rate from high level to low level was S(19.2%),H(12.4%),R(5.0%),E(4.0%).The initial drug resistant rates of single drug and at least 2 drugs were 17.5%% and 9.0% respectively.The initial drug resistant rates was increasing(χ²=34.606,P=0.000)while the initial multi-drug resistance showed a decreasing trend in comparison with 1998/1999,which will produce more Mycobacterium tuberculosis strains of single drug resistance in a specific number of strains in Zhejiang.Conclusion The MDR-TB epidemic was improved,but drug resistant TB was still quite serious in Zhejiang.It is the top priority to further improve DOTS quality.

Key words: Tuberculosis,pulmonary, Drug resistance, Surveillance