关键词: 结核, 肺/预防和控制, 结核, 肺/药物疗法, 抗药性, 多种, 细菌, 微生物敏感性试验, 临床方案, 北京市

Abstract: Objective To describe drug resistance spectrums of tuberculosis(TB) isolates from multidrug-resistant tuberculosis (MDR-TB) suspects, to assess the treatment effect of domestic drug group of MDR-TB and to explore the MDR-TB control strategy which is applicable in Beijing. Methods During the period of April 2008 to March 2013, 1124 MDR-TB suspects were detected by sputum culture in 21 651 patients with active tuberculosis. Drug susceptibility test (DST) was applied to the microbe-positive cultural substances of 885 MDR-TB suspects with strains of Mycobacterium tuberculosis complex, 277 diagnosed MDR-TB patients were treated by domestic drug prescription, and the treatment management methods were selected according to the patient’s situation, and the adverse effect and therapeutic effect were observed.  Results During the 5 years of implementation, MDR-TB patients accounted for 32.1%（284/885）of the MDR-TB suspects with Mycobacterium tuberculosis strains. The proportion of the strains which were sensitive to both the first and the second-line drugs were 21.4%(133/620). Because 7 MDR-TB patients conducted DST again during treatment, there were actually 277 MDR-TB patients detected. Classified management methods were applied to the 277 MDR-TB cases, 127 cases (45.9%) were treated with the second-line drugs in TB control institutes, among whom 76 cases(59.8%) had side effects. The cure rate of the 93 MDR-TB patients who had treatment outcomes were 63.4%(59/93). The proportions of MDR-TB patients maintained the original treatment regimen or referred to a specialized hospital were 17.7%(49/277) and 13.0%(36/277). Conclusion It is essential for the suspected MDR-TB to conduct DST timely to, get early detection of MDR-TB cases and to develop an appropriate treatment regimen to control the spread of multi-drug resistant TB. The classified management for MDR-TB patients gets the ideal effect.

Key words: Tuberculosis, pulmonary/prevention &, control, Tuberculosis, pulmonary/drug therapy, Drug resistance, multiple, bacterial, Microbial sensitivity tests, Clinical protocols, Beijing city