Chinese Journal of Antituberculosis ›› 2022, Vol. 44 ›› Issue (12): 1279-1287.doi: 10.19982/j.issn.1000-6621.20220284
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Shen Hongcheng1, Du Yuhua1, Zhang Danni2, Wu Guifeng1, Lei Yu1, Xiao Xincai1, Liu Jianxiong1()
Received:
2022-07-28
Online:
2022-12-10
Published:
2022-12-02
Contact:
Liu Jianxiong
E-mail:Ljxer64@qq.com
Supported by:
CLC Number:
Shen Hongcheng, Du Yuhua, Zhang Danni, Wu Guifeng, Lei Yu, Xiao Xincai, Liu Jianxiong. Analysis of drug resistance situation and influencing factors among high-risk group of drug-resistant tuberculosis in Guangzhou, 2014—2019[J]. Chinese Journal of Antituberculosis, 2022, 44(12): 1279-1287. doi: 10.19982/j.issn.1000-6621.20220284
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特征 | 例数 | 利福平 耐药[例 (耐药 率,%)] | χ2值 | P值 | 单耐药 [例 (耐药 率,%)] | χ2值 | P值 | 耐多药 [例 (耐药 率,%)] | χ2值 | P值 | 广泛耐 药[例 (耐药 率,%)] | χ2值 | P值 | 总耐药 [例 (耐药 率,%)] | χ2值 | P值 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
性别 | 0.370 | 0.543 | 0.485 | 0.486 | 4.859 | 0.027 | 2.912 | 0.094 | 7.577 | 0.006 | ||||||
男性 | 1703 | 67 (3.93) | 173 (10.16) | 397 (23.31) | 12 (0.70) | 582 (34.17) | ||||||||||
女性 | 452 | 15 (3.32) | 51 (11.28) | 128 (28.32) | 7 (1.55) | 186 (41.15) | ||||||||||
户籍类型 | 1.703 | 0.192 | 0.444 | 0.505 | 35.422 | <0.001 | 5.580 | 0.018 | 28.849 | <0.001 | ||||||
广州市内 | 1254 | 42 (3.35) | 135 (10.77) | 247 (19.70) | 6 (0.49) | 388 (30.94) | ||||||||||
广州市外 | 901 | 40 (4.44) | 89 (9.88) | 278 (30.85) | 13 (1.44) | 380 (42.18) | ||||||||||
年龄组(岁) | 7.717 | 0.052 | 4.386 | 0.223 | 90.627 | <0.001 | 6.379 | 0.076 | 73.434 | <0.001 | ||||||
<25 | 148 | 2 (1.35) | 9 (6.08) | 58 (39.19) | 3 (2.03) | 70 (47.30) | ||||||||||
25~44 | 631 | 31 (4.91) | 64 (10.14) | 207 (32.81) | 9 (1.43) | 280 (44.37) | ||||||||||
45~64 | 967 | 40 (4.14) | 111 (11.48) | 220 (22.75) | 5 (0.52) | 336 (34.75) | ||||||||||
≥65 | 409 | 9 (2.20) | 40 (9.79) | 40 (9.78) | 2 (0.49) | 82 (20.05) | ||||||||||
民族 | 1.520 | 0.218 | 2.209 | 0.182 | 1.939 | 0.164 | 0.363 | 1.000 | 0.175 | 0.676 | ||||||
汉族 | 2115 | 79 (3.74) | 217 (10.26) | 519 (24.54) | 19 (0.90) | 755 (35.70) | ||||||||||
其他 | 40 | 3 (7.50) | 7 (17.5) | 6 (15.00) | 0 | 13 (32.50) | ||||||||||
职业 | 7.804 | 0.305 | 11.100 | 0.130 | 268.541 | <0.001 | 6.209 | 0.429 | 232.076 | <0.001 | ||||||
儿童及学生 | 17 | 0 (0.00) | 0 (0.00) | 7 (41.18) | 0 | 7 (41.18) | ||||||||||
教师、医务人员及干部职员 | 45 | 2 (4.44) | 4 (8.89) | 15 (33.33) | 0 | 19 (42.22) | ||||||||||
商业服务 | 78 | 6 (7.69) | 14 (17.95) | 17 (21.79) | 1 (1.28) | 32 (41.03) | ||||||||||
工人与民工 | 177 | 3 (1.69) | 13 (7.34) | 35 (19.77) | 0 | 48 (27.12) | ||||||||||
农民 | 315 | 10 (3.17) | 39 (12.38) | 53 (16.83) | 2 (0.63) | 94 (29.84) | ||||||||||
家政及待业 | 769 | 36 (4.68) | 74 (9.62) | 125 (16.25) | 7 (0.91) | 206 (26.79) | ||||||||||
离退休人员 | 300 | 11 (3.67) | 37 (12.33) | 29 (9.67) | 1 (0.33) | 67 (22.33) | ||||||||||
其他/不详 | 454 | 14 (3.08) | 43 (9.41) | 244 (53.74) | 8 (1.76) | 295 (64.98) | ||||||||||
患者分类 | 8.487 | 0.110 | 7.137 | 0.199 | 240.150 | <0.001 | 17.274 | 0.004 | 249.833 | <0.001 | ||||||
初治2、3个月末痰涂片阳性 | 531 | 10 (1.88) | 41 (7.72) | 49 (9.23) | 1 (0.19) | 91 (17.14) | ||||||||||
初治失败 | 163 | 7 (4.29) | 19 (11.66) | 97 (59.51) | 3 (1.84) | 119 (73.01`) | ||||||||||
特征 | 例数 | 利福平 耐药[例 (耐药 率,%)] | χ2值 | P值 | 单耐药 [例 (耐药 率,%)] | χ2值 | P值 | 耐多药 [例 (耐药 率,%)] | χ2值 | P值 | 广泛耐 药[例 (耐药 率,%)] | χ2值 | P值 | 总耐药 [例 (耐药 率,%)] | χ2值 | P值 |
复治失败/慢性患者 | 119 | 5 (4.20) | 11 (9.24) | 67 (56.30) | 5 (4.20) | 83 (69.75) | ||||||||||
复发 | 1215 | 56 (4.61) | 142 (11.69) | 267 (21.98) | 8 (0.66) | 417 (34.32) | ||||||||||
返回 | 8 | 0 (0.00) | 0 (0.00) | 1 (12.50) | 0 | 1 (12.50) | ||||||||||
其他 | 119 | 4 (3.36) | 11 (9.24) | 44 (36.97) | 2 (1.68) | 57 (47.90) | ||||||||||
合计 | 2155 | 82 (3.81) | 224 (10.39) | 525 (24.36) | 19 (0.88) | 768 (35.64) |
耐药分类 | 2014年 | 2015年 | 2016年 | 2017年 | 2018年 | 2019年 | 合计 | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | 例数 | 耐药[例 (耐药率, %)] | |||||||
任一耐药 | ||||||||||||||||||||
异烟肼 | 72 | 37(51.39) | 247 | 118(47.77) | 348 | 176(50.57) | 377 | 155(41.11) | 503 | 94(18.69) | 608 | 109(17.93) | 2155 | 689(31.97) | ||||||
利福平 | 72 | 30(41.67) | 247 | 107(43.32) | 348 | 152(43.68) | 377 | 142(37.67) | 503 | 87(17.30) | 608 | 108(17.76) | 2155 | 626(29.05) | ||||||
乙胺丁醇 | 72 | 19(26.39) | 247 | 48(19.43) | 348 | 79(22.70) | 377 | 35(9.28) | 503 | 23(4.57) | 608 | 26(4.28) | 2155 | 231(10.72) | ||||||
氧氟沙星 | 72 | 6(8.33) | 247 | 19(7.69) | 348 | 42(12.07) | 377 | 29(7.69) | 503 | 27(5.37) | 608 | 44(7.24) | 2155 | 167(7.75) | ||||||
卡那霉素 | 72 | 1(1.39) | 247 | 13(5.26) | 348 | 16(4.60) | 377 | 7(1.86) | 503 | 13(2.58) | 608 | 5(0.82) | 2155 | 55(2.55) | ||||||
利福平耐药 | 72 | 3(4.17) | 247 | 8(3.24) | 348 | 10(2.87) | 377 | 22(5.84) | 503 | 18(3.58) | 608 | 21(3.45) | 2155 | 82(3.81) | ||||||
耐多药 | 72 | 27(37.50) | 247 | 95(38.46) | 348 | 137(39.37) | 377 | 114(30.24) | 503 | 67(13.32) | 608 | 85(13.98) | 2155 | 525(24.36) | ||||||
广泛耐药 | 72 | 0(0.00) | 247 | 4(1.62) | 348 | 5(1.44) | 377 | 6(1.59) | 503 | 2(0.40) | 608 | 2(0.33) | 2155 | 19(0.88) |
耐药组合 | 例数 | 构成比(%) |
---|---|---|
耐1种药品 | ||
INH | 117 | 15.23 |
RFP | 69 | 8.98 |
EMB | 0 | 0.00 |
Ofx | 0 | 0.00 |
Km | 0 | 0.00 |
耐2种药品 | ||
INH+RFP | 276 | 35.94 |
INH+EMB | 11 | 1.43 |
INH+Km | 3 | 0.39 |
INH+Ofx | 8 | 1.05 |
RFP+EMB | 5 | 0.66 |
RFP+Ofx | 4 | 0.52 |
耐3种药品 | ||
INH+RFP+EMB | 129 | 16.80 |
INH+RFP+Ofx | 51 | 6.64 |
INH+RFP+Km | 6 | 0.78 |
INH+Ofx+Km | 1 | 0.13 |
INH+Ofx+EMB | 1 | 0.13 |
INH+Km+EMB | 1 | 0.13 |
RFP+Ofx+Km | 1 | 0.13 |
RFP+Ofx+EMB | 1 | 0.13 |
耐4种药品 | ||
INH+RFP+EMB+Ofx | 50 | 6.51 |
INH+RFP+Ofx+Km | 14 | 1.82 |
INH+RFP+EMB+Km | 8 | 1.04 |
耐5种药品 | ||
INH+RFP+EMB+Ofx+Km | 12 | 1.56 |
合计 | 768 | 100.00 |
因素 | 耐药患者(768例) | 非耐药患者(1387例) | χ2值 | P值 | ||
---|---|---|---|---|---|---|
例数 | 构成比(%) | 例数 | 构成比(%) | |||
性别 | 7.577 | 0.006 | ||||
男性 | 582 | 75.78 | 1121 | 80.82 | ||
女性 | 186 | 24.22 | 266 | 19.18 | ||
户籍类型 | 28.849 | <0.001 | ||||
广州市内 | 388 | 50.52 | 866 | 62.44 | ||
广州市外 | 280 | 49.48 | 521 | 37.56 | ||
因素 | 耐药患者(768例) | 非耐药患者(1387例) | χ2值 | P值 | ||
例数 | 构成比(%) | 例数 | 构成比(%) | |||
年龄组 | 73.434 | <0.001 | ||||
<25岁 | 70 | 9.11 | 78 | 5.62 | ||
25~44岁 | 280 | 36.46 | 351 | 25.31 | ||
45~64岁 | 336 | 43.75 | 631 | 45.49 | ||
≥65岁 | 82 | 10.68 | 327 | 23.58 | ||
民族 | 0.175 | 0.676 | ||||
汉族 | 755 | 98.31 | 1360 | 98.05 | ||
其他 | 13 | 1.69 | 27 | 1.95 | ||
职业 | 232.076 | <0.001 | ||||
儿童及学生 | 7 | 0.91 | 10 | 0.72 | ||
教师、医务人员及干部职员 | 19 | 2.47 | 26 | 1.87 | ||
商业服务 | 32 | 4.17 | 46 | 3.32 | ||
工人与民工 | 48 | 6.25 | 129 | 9.30 | ||
农民 | 94 | 12.24 | 221 | 15.93 | ||
家政及待业 | 206 | 26.82 | 563 | 40.59 | ||
离退休人员 | 67 | 8.72 | 233 | 16.80 | ||
其他/不详 | 295 | 38.42 | 159 | 11.47 | ||
患者分类 | 249.833 | <0.001 | ||||
初治2、3个月末痰涂片阳性 | 91 | 11.85 | 440 | 31.72 | ||
初治失败 | 119 | 15.49 | 44 | 3.17 | ||
复治失败/慢性患者 | 83 | 10.81 | 36 | 2.60 | ||
复发 | 417 | 54.30 | 798 | 57.53 | ||
返回 | 1 | 0.13 | 7 | 0.50 | ||
其他 | 57 | 7.42 | 62 | 4.48 |
因素 | β值 | s | Wald χ2值 | P值 | OR(95%CI)值 |
---|---|---|---|---|---|
常量 | -1.093 | 0.520 | 4.416 | 0.036 | 0.335 |
女性 | 0.104 | 0.126 | 0.684 | 0.408 | 1.109(0.867~1.419) |
广州市外户籍 | 0.097 | 0.113 | 0.740 | 0.390 | 1.102(0.884~1.374) |
年龄组(岁) | |||||
<25 | 1.000 | ||||
25~44 | 0.022 | 0.214 | 0.011 | 0.916 | 1.023(0.673~1.554) |
45~64 | -0.230 | 0.215 | 1.136 | 0.286 | 0.795(0.521~1.212) |
≥65 | -0.971 | 0.263 | 13.641 | <0.001 | 0.379(0.226~0.634) |
职业 | |||||
离退休人员 | 1.000 | ||||
商业服务 | 0.883 | 0.269 | 10.809 | 0.001 | 2.419(1.429~4.096) |
工人与民工 | 0.258 | 0.219 | 1.390 | 0.238 | 1.294(0.843~1.986) |
家政及待业 | 0.241 | 0.161 | 2.246 | 0.134 | 1.272(0.929~1.744) |
教师、医务人员及干部职员 | 0.933 | 0.332 | 7.886 | 0.005 | 2.541(1.325~4.873) |
农民 | 0.391 | 0.185 | 4.458 | 0.035 | 1.479(1.028~2.127) |
学生及儿童 | 0.890 | 0.512 | 3.020 | 0.082 | 2.434(0.893~6.640) |
其他 | 1.864 | 0.170 | 120.294 | 0.000 | 6.452(4.624~9.003) |
患者分类 | |||||
初治2、3个月末痰涂片阳性 | 1.000 | ||||
初治失败 | 2.245 | 0.223 | 101.361 | 0.000 | 9.443(6.099~14.621) |
返回 | -0.446 | 1.092 | 0.166 | 0.683 | 0.640(0.075~5.450) |
复发 | 0.943 | 0.136 | 48.384 | 0.000 | 2.567(1.968~3.348) |
复治失败/慢性患者 | 2.015 | 0.246 | 67.170 | 0.000 | 7.504(4.634~12.151) |
其他 | 1.131 | 0.230 | 24.160 | 0.000 | 3.091(1.969~4.854) |
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