关键词: 结核, 肺/药物疗法, 抗药性, 多种, 细菌, 重庆市

Abstract: Objective For the purpose of providing scientific evidence for the prevention and treatment model of drug-resistant TB,we analyzed the current situation on the detection and treatment of MDR-TB patients of 6 districts and counties in Chongqing. Methods All 1189 smear-positive patients were collected from the 6 districts and counties of the 3 Gorges reservoir region,1015 cases were new smear-positive TB patients and 174 cases were from high risk patients of MDR-TB. The drug-susceptibility test results, transporting situation and the causes who were not included in the treatment were analyzed. Results Among 1189 smear-positive patients,84 cases(7.1%)were diagnosed as MDR-TB. Comparing multidrug-resistant detection rate in different gender，the male was 6.9% (61/883), the female was 7.5% (23/306); there was no statistical differences between genders with the detection rate of multidrug-resistant(χ²=0.07,P＞0.05).Comparing different age groups，≤20 years, >20 years-,41 years- and 61-80 years old were 6.9% (7/102), 8.7% (25/286), 7.8% (39/499), 4.3% (13/302) respectively; there was no statistical differences between different age groups with the detection rate of multidrug-resistant(χ²=2.15,P＞0.05). From the point of patient classification, new smear-positive pulmonary tuberculosis patients with multidrug-resistant detection rate was 3.6%(37/1015),the detection rate from high risk population was 27.0%(47/174), the difference was statistically significant (χ²=123.5,P＜0.01). The overall time interval (d) for suspected multi-drug resistant patients between leave phlegm to carry out drug sensitive test was an average of 90.9 d (66.0-118.9 d). In 84 cases of multi-drug resistant TB diagnosis, 22 cases received treatment, the treatment rate was 26.2% (22/84); and 62 cases were out of treatment and economic difficulties was the priority reason accounting for 41.9%(26/62). Conclusion The screening for MDR-TB should target at the high risk population in Chongqing city, we should set up standardized diagnosis and treatment management points of MDR-TB nearby designated TB hospitals, and carry out medical insurance policy, addressing patient clinic costs, in order to ensure patients’s standardized treatment.

Key words: Tuberculosis, pulmonary/drug therapy, Drug resistance, multiple, bacterial, Chongqing city