Please wait a minute...
文章检索
预防医学  2016, Vol. 28 Issue (8): 757-761,765    
  论著 本期目录 | 过刊浏览 | 高级检索 |
浙江省结核病耐药状况分析
陈松华,吴蓓蓓,柳正卫,何海波,潘爱珍,王飞,张明五,周琳,张钰,王晓萌
浙江省疾病预防控制中心,浙江杭州 310051
An analysis on the epidemic characteristics of tuberculosis drug resistance in Zhejiang Province
CHEN Song-hua,WU Bei-bei,LIU Zheng-wei,HE Hai-bo,PAN Ai-zhen,WANG Fei,ZHANG Ming-wu,ZHOU lin,ZHANG Yu,WANG Xiao-meng
The Centre for Disease Control and Prevention of Zhejiang Province,Hangzhou,Zhejiang,310051,China
全文: PDF(629 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 通过结核病耐药监测,了解浙江省结核病耐药状况,为耐药结核病疫情控制提供依据。方法 在浙江省随机抽取30个县(区),对样本县(区)2013年7月1日—2014年6月30日发现的涂阳患者做细菌培养,将其中结核分枝杆菌(TB)培养阳性的菌株纳入耐药分析。结果 共纳入1 010例涂阳患者,其中51例(5.05%)鉴定为非TB,936例(92.67%)鉴定为TB,23例(2.28%)培养细菌未生长。浙江省结核病总耐药率为30.88%,耐多药率为5.02%。其中初治耐药率29.22%,耐多药率3.21%;复治耐药率45.74%,耐多药率21.28%。13种纳入监测的抗结核药物均存在耐药现象,链霉素(SM)总耐药率最高(15.28%),氨基糖苷类相对较低(2.35%)。初治患者中SM耐药率最高(14.37%),耐药谱系比例较高的为耐SM、丙硫异烟胺、异烟肼(INH)、INH+SM和氧氟沙星+左氧氟沙星+莫西沙星;复治患者中INH耐药率最高(30.85%),耐药谱系比例较高的为耐SM、INH+利福平(RFP)、INH+RFP+SM、INH和RFP。复治患者总耐药率、耐多药率、一线抗结核药物耐药率以及对INH、RFP、SM、乙胺丁醇、卡那霉素和对氨基水杨酸的耐药率均比初治患者高(P<0.05)。结论 浙江省结核病患者初治耐药率较以往有所上升,表明耐药菌株的原发传播并未得到有效控制;复治耐药率和耐多药率均有所下降,表明实施标准短程化疗方案已取得一定成效;SM的高耐药率提示现有治疗方案中SM尚需商榷。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
陈松华
吴蓓蓓
柳正卫
何海波
潘爱珍
王飞
张明五
周琳
张钰
王晓萌
关键词 结核病结核分枝杆菌耐药耐多药    
AbstractObjective To monitor the drug resistance of tuberculosis in Zhejiang Province and to provide scientific evidence for the control of drug resistant tuberculosis.Methods Thirty counties in Zhejiang Province were selected as sample during July 1, 2013 and June 30 2014, and smear positive cases were selected to be monitored during study period.Results The rate of drug resistance was 30.88%, and the rate of multi drug resistance was 5.02%. The rate of the extensively drug-resistant tuberculosis was 0.32%. Among initial treatment cases, the rate of drug resistance was 29.22%, higher than 2008, and the rate of multi drug resistance was 3.21%.Among retreatment cases, the rate of drug resistance was 45.74%, and the rate of multi drug resistance was 21.28%. All kinds of monitored drugs were found resistance phenomenon. The drug resistant rate of SM was highest (15.28%), and aminoglycosides (2.35%) were relatively low.Conclusion The status of retreatment TB drug resistance suggested that we had reduced acquired TB drug resistance through implementation of DOTS strategy and standard short course chemotherapy treatment in Zhejiang Province. But it is still not optimistic to control TB drug resistance, and the status of initial treatment TB resistant suggested that resistant strains spread had not been effectively controlled in Zhejiang Province. So we should strengthen the early detection of drug resistant among TB patients,and to further improve the standard of conventional TB treatment.
Key wordsTuberculosis    Mycobacterium tuberculosis    Drug resistance    Multi-drug resistance
          出版日期: 2016-08-26
中图分类号:  R521  
基金资助:浙江省重大科技专项计划项目(2014C03034);浙江省医药卫生科技计划项目(2015KYA056、2015KYB079)
通信作者: 王晓萌,E-mail:xmwang@cdc.zj.cn   
作者简介: 陈松华,硕士,主任医师,主要从事结核病防制工作通信作者王晓萌,E-mailxmwang@cdc.zj.cn
引用本文:   
陈松华, 吴蓓蓓, 柳正卫, 何海波, 潘爱珍, 王飞, 张明五, 周琳, 张钰, 王晓萌. 浙江省结核病耐药状况分析[J]. 预防医学, 2016, 28(8): 757-761,765.
CHEN Song-hua, WU Bei-bei, LIU Zheng-wei, HE Hai-bo, PAN Ai-zhen, WANG Fei, ZHANG Ming-wu, ZHOU lin, ZHANG Yu, WANG Xiao-meng. An analysis on the epidemic characteristics of tuberculosis drug resistance in Zhejiang Province. Preventive Medicine, 2016, 28(8): 757-761,765.
链接本文:  
http://www.zjyfyxzz.com/CN/      或      http://www.zjyfyxzz.com/CN/Y2016/V28/I8/757
[1]World Health Organization. Hepatitis B [R]. Geneva: World Health Organization, 2015.
[2]郭敏建,姚军,李静.成人乙肝疫苗不同免疫程序效果观察[J].浙江预防医学, 2015,27(8):757-760.
[3]WHO.Hepatitis B vaccines: WHO position paper[J]. Weekly epidemiological record, 2009,84(40):405-420.
[4]庄贵华,颜虹,王学良.乙型肝炎疫苗接种无应答解决对策[J].中华预防医学杂志,2007,41(5):403-406.
[5]GHEBREHEWET S, BAXTER D, FALCONER M, et al. Intradermal recombinant hepatitis B vaccination(IDRV) for non-responsive healthcare workers(HCWs)[J]. Hum Vaccin. 2008,4(4):280-285.
[6]陈胜玉,王学才,董晓莲,等.成人重组酵母乙肝疫苗两种不同免疫程序接种效果观察[J].中国预防医学杂志,2013,14(2):96-98.
[7]ZHANG W, HAN L,LIN C,et al. Surface antibody and cytokine response to recombinant Chinese hamster ovary cell(CHO) hepatitis B vaccine[J]. Vaccine,2011,29(37): 6276-6282.
[8]蒋汝刚,付翔,周静,等.成年人接种乙肝疫苗后无(弱)应答状况及其影响因素分析[J].中华疾病控制杂志,2011,15(3):210-212.
[9]RAMEZANI A, AGHASADEGHI M R, AHMADI F,et al.Isolated anti-HBc and occult HBV infection in dialysis patients[J]. Nephro-urology Monthly,2015,7(1):e22674.
[10]叶贤林,杜鹏,冯旭,等.深圳市18~25岁抗-HBc阳性合格献血者隐匿性乙肝病毒感染的血清学和分子生物学特性分析[J].中国输血杂志,2014,11(27):1112-1115.
[11]GESSONI G, BEGGIO S, BARIN P,et al. Significance of anti-HBc only in blood donors: a serological and virological study after hepatitis B vaccination[J]. Blood Transfus,2014,12(1):S63-S68.
[12]周波青,徐峰,张艳,等.不同免疫程序成人重组乙型肝炎疫苗(汉逊酵母)接种免疫效果比较研究[J].中国疫苗和免疫,2015,21(5):495-498.
[13]YAO J,LI J,CHEN Y,et al. The response of hepatitis B vaccination on seronegative adults with different vaccination schedules[J].Human Vaccines and Immunotherapeutics,2015,11(5):1102-1107.
[14]吕静静,颜丙玉,陈士玉,等.成人乙型肝炎疫苗初免低应答后加强免疫及影响因素分析[J].山东大学学报(医学版),2012,50(11):126-132.
[15]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病学杂志,2011,19(1):13-24.
[16]曾滢,宋雪芳,潘红星,等.成人乙肝疫苗无应答者复种效果研究[C].第五次全国免疫诊断暨疫苗学术研讨会论文汇编,2011.
[17]杨培娟.大学生乙型肝炎疫苗无应答者再免疫一剂60 μg疫苗的效果观察[J].中华预防医学杂志,2013,47(10):966-967.
[1] 王远航, 胡洁, 葛锐, 富小飞, 亓云鹏. 嘉兴市结核分枝杆菌耐药情况分析[J]. 预防医学, 2023, 35(8): 705-709.
[2] 胡嘉, 黄钦, 郑建刚, 何旺瑞, 曾艳文. 江西省居民结核病防治核心信息知晓情况调查[J]. 预防医学, 2023, 35(8): 718-720,731.
[3] 赵雪蕾, 周鹏, 安戈, 李羿, 张晓甍, 程春荣. 郑州市非伤寒沙门菌血清型和耐药性分析[J]. 预防医学, 2023, 35(4): 335-338.
[4] 刘海霞, 耿英芝, 王伟杰, 李雪, 张眉眉. 肉与肉制品空肠弯曲菌耐药性和多位点序列分型[J]. 预防医学, 2023, 35(4): 342-344,349.
[5] 刘方, 王岚, 湛志飞, 张林青, 袁青, 陈帅. 湖南省815株沙门菌血清型和耐药性分析[J]. 预防医学, 2023, 35(2): 134-136,140.
[6] 马丽, 梁智超, 陈阳贵, 张为胜, 毛宏凯, 胥婉婷, 曹明芹. 2010—2019年乌鲁木齐市学生结核病病例发现延迟、就诊延迟、确诊延迟分析[J]. 预防医学, 2023, 35(1): 53-56,60.
[7] 夏强, 刘海灿, 赵秀芹, 万康林, 赵丽丽. 结核分枝杆菌异烟肼与乙硫异烟胺交叉耐药的相关基因研究[J]. 预防医学, 2022, 34(8): 836-841.
[8] 雷蓉蓉, 张婷, 吴成果, 罗建奎, 汪清雅, 任昌理. 南川区居民结核潜伏感染调查[J]. 预防医学, 2022, 34(4): 371-374.
[9] 赵雪蕾, 周鹏, 安戈, 李羿, 张晓甍, 程春荣. 郑州市儿童感染性腹泻病原菌监测结果[J]. 预防医学, 2022, 34(4): 389-394.
[10] 马志, 叶尔扎提·吾瓦特, 腾子豪, 蒋远东, 向阳. 2009—2020年伊宁市学生结核病就诊延迟情况调查[J]. 预防医学, 2022, 34(2): 180-184.
[11] 腾子豪, 蒋远东, 王玥, 王艳杰, 樊晓蕾, 胡鹏远, 向阳. 新疆某职业院校新生结核潜伏感染的影响因素分析[J]. 预防医学, 2022, 34(11): 1156-1160.
[12] 桑国鑫, 陈同, 车洋, 陈云鹏, 贺天锋. 宁波市结核分枝杆菌和艾滋病病毒双重感染筛查结果[J]. 预防医学, 2022, 34(11): 1121-1124.
[13] 黄飞飞, 王波, 张宁, 王小龙, 邹文燕. 苏州市某奶牛养殖场及市售生畜肉产志贺毒素大肠埃希菌分子流行病学分析[J]. 预防医学, 2022, 34(10): 1031-1037.
[14] 王云霞, 郑娟娟, 张娟娟, 黄佩佩, 梅金周, 袁青. 2011—2018年宝安区肺结核患者耐多药的影响因素分析[J]. 预防医学, 2021, 33(7): 701-703.
[15] 张婷, 刘珊珊, 汪清雅, 张娅, 李建琼, 陈健. 重庆市疾控机构耐药肺结核治疗管理评价指标体系构建[J]. 预防医学, 2021, 33(6): 592-594,598.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed