Chinese Journal of Antituberculosis ›› 2020, Vol. 42 ›› Issue (11): 1214-1220.doi: 10.3969/j.issn.1000-6621.2020.11.013
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SONG Ke-yu, ZHANG Qin, WANG Wen-jing, SHI Rui, WU Xu-ping()
Received:
2020-02-26
Online:
2020-11-10
Published:
2020-11-13
Contact:
WU Xu-ping
E-mail:xuping_wu@126.com
SONG Ke-yu, ZHANG Qin, WANG Wen-jing, SHI Rui, WU Xu-ping. Analysis of drug-resistance of 1719 mycobacterium strains in Nanjing from 2017 to 2019[J]. Chinese Journal of Antituberculosis, 2020, 42(11): 1214-1220. doi: 10.3969/j.issn.1000-6621.2020.11.013
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临床特征 | NTM感染者 | MTB感染者 | ||
---|---|---|---|---|
例数 | 构成比(%) | 例数 | 构成比(%) | |
年龄组(岁) | ||||
0~ | 1 | 0.33 | 7 | 0.50 |
15~ | 15 | 4.87 | 422 | 29.90 |
35~ | 142 | 46.10 | 647 | 45.85 |
≥65 | 150 | 48.70 | 335 | 23.75 |
性别 | ||||
男 | 152 | 49.35 | 1027 | 72.79 |
女 | 156 | 50.65 | 384 | 27.21 |
患者类型 | ||||
初治 | 81 | 26.30 | 498 | 35.29 |
复治 | 227 | 73.70 | 913 | 64.71 |
并发艾滋病 | ||||
否 | 300 | 97.40 | 1339 | 94.90 |
是 | 8 | 2.60 | 72 | 5.10 |
合计 | 308 | 100.00 | 1411 | 100.00 |
临床特征 | 例数 | 耐药 | 耐多药 | |||||||
---|---|---|---|---|---|---|---|---|---|---|
例数 | 耐药率 (%) | χ2值 | P值 | 例数 | 耐多药率 (%) | χ2值 | P值 | |||
年龄组(岁) | - | 0.001 | - | 0.000 | ||||||
0~ | 7 | 2 | 2/7 | 1 | 1/7 | |||||
15~ | 422 | 140 | 33.18 | 52 | 12.32 | |||||
35~ | 647 | 233 | 36.01 | 104 | 16.07 | |||||
≥65 | 335 | 78 | 23.28 | 15 | 4.48 | |||||
性别 | 0.458 | 0.499 | 0.013 | 0.928 | ||||||
男 | 1027 | 335 | 32.62 | 128 | 12.46 | |||||
女 | 384 | 118 | 30.73 | 47 | 12.24 | |||||
患者类型 | 5.076 | 0.024 | 7.099 | 0.008 | ||||||
初治 | 498 | 141 | 28.31 | 46 | 9.24 | |||||
复治 | 913 | 312 | 34.17 | 129 | 14.13 | |||||
并发艾滋病 | 0.652 | 0.419 | 1.270 | 0.260 | ||||||
否 | 1339 | 433 | 32.34 | 163 | 12.17 | |||||
是 | 72 | 20 | 27.78 | 12 | 16.67 | |||||
合计 | 1411 | 453 | 32.10 | 175 | 12.40 |
药品 | 合计(308株) | 初治患者分离株(81株) | 复治患者分离株(227株) | χ2值 | P值 | |||
---|---|---|---|---|---|---|---|---|
耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | |||
INH | 302 | 98.05 | 80 | 98.77 | 222 | 97.80 | - | 1.000 |
Sm | 300 | 97.40 | 80 | 98.77 | 220 | 96.92 | - | 0.686 |
RFP | 278 | 90.26 | 72 | 88.89 | 206 | 90.75 | 0.235 | 0.628 |
EMB | 125 | 40.58 | 30 | 37.04 | 95 | 41.85 | 0.574 | 0.449 |
Lfx | 280 | 90.91 | 75 | 92.59 | 213 | 93.83 | 0.151 | 0.697 |
Km | 287 | 93.18 | 78 | 96.30 | 209 | 92.07 | 1.678 | 0.195 |
Am | 294 | 95.45 | 78 | 96.30 | 216 | 95.15 | - | 1.000 |
Cm | 285 | 92.53 | 78 | 96.30 | 207 | 91.19 | 2.253 | 0.133 |
PAS | 297 | 96.43 | 79 | 97.53 | 218 | 96.04 | - | 0.734 |
药品 | 合计(1411株) | 初治患者分离株(498株) | 复治患者分离铢(913株) | χ2值 | P值 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | ||||||||||
INH | 249 | 17.65 | 72 | 14.46 | 177 | 19.39 | 5.386 | 0.020 | |||||||
Sm | 242 | 17.15 | 71 | 14.26 | 169 | 18.51 | 4.130 | 0.042 | |||||||
RFP | 189 | 13.39 | 53 | 10.64 | 136 | 14.90 | 6.455 | 0.024 | |||||||
EMB | 91 | 6.45 | 18 | 3.61 | 73 | 8.00 | 10.252 | 0.001 | |||||||
Lfx | 151 | 10.70 | 46 | 9.24 | 105 | 11.50 | 1.728 | 0.189 | |||||||
Km | 34 | 2.41 | 5 | 1.00 | 29 | 3.18 | 6.466 | 0.011 | |||||||
Am | 62 | 4.39 | 20 | 4.02 | 42 | 4.60 | 0.262 | 0.609 | |||||||
Cm | 17 | 1.20 | 4 | 0.80 | 13 | 1.42 | 1.043 | 0.307 | |||||||
PAS | 26 | 1.84 | 9 | 1.81 | 17 | 1.86 | 0.005 | 0.942 | |||||||
耐药 | 453 | 32.10 | 141 | 28.31 | 312 | 34.17 | 5.076 | 0.024 | |||||||
单耐药 | 135 | 9.57 | 51 | 10.24 | 84 | 9.20 | 0.403 | 0.525 | |||||||
药品 | 合计(1411株) | 初治患者分离株(498株) | 复治患者分离铢(913株) | χ2值 | P值 | ||||||||||
耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | 耐药菌株数(株) | 耐药率(%) | ||||||||||
多耐药 | 62 | 4.39 | 20 | 4.02 | 42 | 4.60 | 0.262 | 0.609 | |||||||
耐多药 | 175 | 12.40 | 46 | 9.24 | 129 | 14.13 | 7.099 | 0.008 | |||||||
广泛耐药 | 26 | 1.84 | 2 | 0.40 | 24 | 2.63 | 8.836 | 0.003 | |||||||
耐任意一线药品 | 436 | 30.90 | 131 | 26.31 | 305 | 33.41 | 7.610 | 0.006 | |||||||
耐任意二线药品 | 212 | 15.02 | 64 | 12.851 | 48 | 16.21 | 4.822 | 0.028 |
药品 | 药敏检测 耐药(株) | 基因突变 (株) | 基因型与表型耐 药符合率 (%) | 耐药位点 | 突变株数 | 突变率 (%) |
---|---|---|---|---|---|---|
RFP | 189 | 186 | 98.41 | rpoB 507~512 | 21 | 11.29 |
rpoB 513~520 | 13 | 6.99 | ||||
rpoB 521~528 | 28 | 15.05 | ||||
rpoB 529~533 | 124 | 66.67 | ||||
rpoB基因双位点 | 15 | 8.06 | ||||
INH | 249 | 217 | 87.15 | ahpC 启动子区 | 21 | 9.68 |
inhA启动子区 | 39 | 17.97 | ||||
katG 315 | 142 | 65.44 | ||||
katG 缺失 | 15 | 6.91 | ||||
ahpC和InhA双基因 | 1 | 0.46 | ||||
ahpC和katG双基因 | 2 | 0.92 | ||||
EMB | 91 | 86 | 94.51 | embB 306 | 57 | 66.28 |
embB 378 | 5 | 5.81 | ||||
embB 406 | 18 | 20.93 | ||||
embB 497 | 6 | 6.98 | ||||
embB基因双位点 | 3 | 3.49 | ||||
Sm | 30 | 26 | 86.67 | rpsL 43 | 18 | 69.23 |
rpsL 88 | 8 | 30.77 | ||||
rrs 513~517 | 0 | 0.00 | ||||
氟喹诺酮类药品 | 91 | 91 | 100.00 | gyrA 88~94 | 91 | 100.00 |
gyrB | 0 | 0.00 | ||||
二线注射类药品 | 30 | 26 | 86.67 | rrs1401 | 26 | 100.00 |
rrs1402 | 0 | 0.00 | ||||
rrs1473 | 0 | 0.00 | ||||
rrs1484 | 0 | 0.00 | ||||
eis启动子区 | 0 | 0.00 |
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