上海市结核分枝杆菌耐药性监测研究报告

摘要/Abstract

摘要： 目的完善上海市结核病耐药监测网络,获得国际可比性的结核病耐药率资料,评价现行结核病控制策略的效果。方法按照WHO/IUATLD的标准,采用100%诊断中心抽样方法,全市各区县结核病定点医院2004年2月—2005年1月诊治的所有新发及复治培阳肺结核病例同时纳入,并对所有分离培养阳性菌株进行菌型鉴定及利福平(RFP)、异烟肼(INH)、链霉素(SM)及乙胺丁醇(EMB)敏感性测试。结果共入选1076例培养阳性肺结核患者,最后获得1015例(94.3%)患者的菌型鉴定及药敏结果,其中结核分枝杆菌964例,占95.0%;非结核分枝杆菌51例,占5.0%。肺结核患者初始耐药率为15.4%(118/764),初始耐多药率为3.9%(30/764);获得性耐药率为27.5%(55/200),耐多药率为12.5%(25/200)。结论上海市结核病耐药率仍然处于国际上相对较高的水平,今后要进一步加强耐药结核病的防治工作。

关键词: 结核,肺, 耐药性

Abstract: Objective To determine the prevalence of primary and acquired drug resistance in M.tuberculosis,and to improve the drug resistance surveillance system in Shanghai. Methods According to WHO/IUATLD guidelines for anti-tuberculosis drug resistance surveillance,sampling method of 100% diagnostic center was adopted.All sputum culture-positive patients among local residents registered at any district(county) tuberculosis dispensary in Shanghai from February 2004 to January 2005 were enrolled.Species identification and drug susceptibility tests were performed on all samples. Results 1 076 patients were enrolled during the study period,in which 1015 patients had the Results of identification and susceptibility.Of 1 015 strains,964(95.0%)M.tuberculosis and 51(5.0%)non-tuberculosis mycobacteria were identified.The prevalence of drug-resistant M.tuberculosis among new cases and re-treatment cases was 15.4%(118/764) and 27.5%(55/200),respectively.The prevalence of MDR-tuberculosis among new cases and re-treatment cases was 3.9%(30/764)and 12.5%(25/200),respectively. Conclusion The prevalence of drug-resistant tuberculosis was severe in Shanghai,suggesting the necessary to strengthen the TB control program.

Key words: Tuberculosis,pulmonary, Drug resistance

梅建,沈鑫,沈梅,桂晓虹,孙斌,. 上海市结核分枝杆菌耐药性监测研究报告[J]. 中国防痨杂志, 2007, 29(5): 395-398.

Mei Jian,Shen Xin,Shen Mei,et al.. Survey of drug-resistant M.tuberculosis in Shanghai,China[J]. Chinese Journal of Antituberculosis, 2007, 29(5): 395-398.

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