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预防医学  2023, Vol. 35 Issue (8): 705-709    DOI: 10.19485/j.cnki.issn2096-5087.2023.08.013
  疾病监测 本期目录 | 过刊浏览 | 高级检索 |
嘉兴市结核分枝杆菌耐药情况分析
王远航, 胡洁, 葛锐, 富小飞, 亓云鹏
嘉兴市疾病预防控制中心传染病预防控制科,浙江 嘉兴 314050
Drug resistance surveillance in Mycobacterium tuberculosis in Jiaxing City
WANG Yuanhang, HU Jie, GE Rui, FU Xiaofei, QI Yunpeng
Department of Communicable Disease Control and Prevention, Jiaxing Center for Disease Control and Prevention, Jiaxing, Zhejiang 314050, China
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摘要 目的 了解2017—2019年浙江省嘉兴市结核分枝杆菌对一线抗结核药物的耐药情况,为提高肺结核治疗效果提供依据。方法 通过中国疾病预防控制信息系统结核病管理信息系统,收集2017—2019年嘉兴市1 310例肺结核患者监测资料,包括人口学信息、治疗分类、痰培养和药敏检测结果等,采用描述性流行病学方法分析结核分枝杆菌对异烟肼(INH)、利福平(RFP)、链霉素(SM)和乙胺丁醇(EMB)的耐药谱、耐药率和耐药类型。结果 2017—2019年嘉兴市分离出结核分枝杆菌1 310株,对至少1种抗结核药物耐药259株,耐药率为19.77%;INH、SM、RFP和EMB耐药率分别为13.36%、11.83%、5.50%和3.59%。复治患者分离株耐药率为34.58%,高于初治患者的18.45%(P<0.05)。耐1种药以SM和INH耐药率较高,分别为4.50%和4.35%;耐2种药组合中以INH+SM耐药率较高,为3.28%;耐3种药组合以INH+RFP+SM耐药率较高,为1.83%;耐4种药有16株,耐药率为1.22%。单耐药率、RFP耐药率、多耐药率和耐多药率分别为10.31%、5.50%、4.73%和4.73%。2017—2019年全部患者和初治患者RFP耐药率呈逐年上升趋势(P<0.05)。省间流动患者分离株RFP耐药率和耐多药率分别为7.01%和6.01%,均高于本地非流动患者的3.76%和3.25%(P<0.05)。结论 2017—2019年嘉兴市结核分枝杆菌耐药率低于浙江省水平,主要为INH和RFP耐药。
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王远航
胡洁
葛锐
富小飞
亓云鹏
关键词 肺结核结核分枝杆菌一线抗结核药物耐药    
AbstractObjective To investigate the resistance of Mycobacterium tuberculosis to first-line anti-tuberculosis drugs in Jiaxing City, Zhejiang Province from 2017 to 2019, so as to provide insights into improvements of the therapeutic effect of pulmonary tuberculosis. Methods Data pertaining to pulmonary tuberculosis in Jiaxing City from 2017 to 2019 were collected from the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, including demographics, treatment classification, sputum culture and drug resistance. The spectrum, types and prevalence of drug resistance in M. tuberculosis to four first-line tuberculosis drugs, including isoniazid (INH), rifampicin (RFP), streptomycin (SM) and ethambutol (EMB), was analyzed using a descriptive epidemiological method. Results A total of 1 310 M. tuberculosis isolates were cultured from pulmonary tuberculosis patients in Jiaxing City from 2017 to 2019, and there were 259 M. tuberculosis isolates that were resistant to anti-tuberculosis drugs, with an overall drug resistance rate of 19.77%. The prevalence rates of drug resistance to INH, SM, RFP and EMB were 13.36%, 11.83%, 5.50% and 3.59%, respectively. The prevalence of drug resistance was lower in M. tuberculosis isolates from treatment-naïve patients than from retreated patients (18.45% vs. 34.58%, P<0.05). M. tuberculosis isolates presented high resistance to SM (4.50%) and INH alone (4.35%), the highest resistance to INH-SM combinations (3.28%), and the highest resistance to INH+RFP+SM combinations (1.83%). Sixteen isolates were resistant to all the four drugs, with a drug resistance rate of 1.22%. The proportions of resistance to a single drug, RFP resistance, multidrug resistance and resistance to two and more drugs were 10.31%, 5.50%, 4.73% and 4.73%, respectively. In addition, the prevalence of RFP resistance among all patients and treatment-naïve patients both showed a tendency towards a rise from 2017 to 2019 (P<0.05). The prevalence of RFP resistance (7.01% vs. 3.76%) and resistance to two and more drugs (6.01% vs. 3.25%) was both higher among interprovincial mobile tuberculosis patients than among local non-mobile patients (P<0.05). Conclusions The overall prevalence of drug resistance was lower in M. tuberculosis isolates in Jiaxing City from 2017 to 2019 than in Zhejiang Province, with INH and RFP resistance as predominant types.
Key wordspulmonary tuberculosis    Mycobacterium tuberculosis    first-line anti-tuberculosis drug    drug resistance
收稿日期: 2023-06-01      修回日期: 2023-07-27      出版日期: 2023-08-10
中图分类号:  R521  
基金资助:嘉兴市科技计划项目(2022AY30026)
作者简介: 王远航,硕士,主管医师,主要从事传染病预防控制工作
通信作者: 富小飞,E-mail:7880774@qq.com   
引用本文:   
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.
WANG Yuanhang, HU Jie, GE Rui, FU Xiaofei, QI Yunpeng. Drug resistance surveillance in Mycobacterium tuberculosis in Jiaxing City. Preventive Medicine, 2023, 35(8): 705-709.
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https://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.08.013      或      https://www.zjyfyxzz.com/CN/Y2023/V35/I8/705
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