中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2011年
9期
544-548
,共5页
刘一典%唐神结%张青%景玲杰%韩敏%乐军
劉一典%唐神結%張青%景玲傑%韓敏%樂軍
류일전%당신결%장청%경령걸%한민%악군
分枝杆菌,结核%药物耐受性%微生物敏感性试验%抗药性,多种,细菌%异烟肼%氧氟沙星
分枝桿菌,結覈%藥物耐受性%微生物敏感性試驗%抗藥性,多種,細菌%異煙肼%氧氟沙星
분지간균,결핵%약물내수성%미생물민감성시험%항약성,다충,세균%이연정%양불사성
Mycobacterium tuberculosis%Drug tolerance%Microbial sensitivity tests%Drug resistance,multiple,bacterial%lsoniazid%Ofloxacin
目的 了解结核分枝杆菌分离株对一线和二线抗结核药物的耐药性。方法 收集2008年1月至2009年3月采用Bactec-MGIT 960检测的518株结核分枝杆菌，分析药物敏感试验结果。数据行x2检验。结果518株结核分枝杆菌菌株对一线和二线抗结核药物全敏感168株，占32.44％；耐药350株，占67.56％;单耐药72株，占13.90％；耐两种药24株，占4.63％；耐三种及以上药254株，占49.03％。217株为耐多药菌株，占所有病例的41.89％。65株为广泛耐药菌株，占所有病例的12.55％，占耐多药菌的29.95％。在一线药物中，耐异烟肼有278株，耐药率达53.67％；二线药物中，耐氧氟沙星有206株，耐药率达39.77％。433例复治患者任一药物耐药率、耐多药率和广泛耐药率分别为72.05％、46.42％和13.86％，均高于初治患者的44.70％、18.82％和5.88％（x2 =24.253，x2=22.229，x2=4.117，均P＜0.01）。结论 上海地区结核病专科医院结核分枝杆菌分离株的耐药率高，且耐多药与广泛耐药率也较高，在复治患者中耐药情况更严重。
目的 瞭解結覈分枝桿菌分離株對一線和二線抗結覈藥物的耐藥性。方法 收集2008年1月至2009年3月採用Bactec-MGIT 960檢測的518株結覈分枝桿菌，分析藥物敏感試驗結果。數據行x2檢驗。結果518株結覈分枝桿菌菌株對一線和二線抗結覈藥物全敏感168株，佔32.44％；耐藥350株，佔67.56％;單耐藥72株，佔13.90％；耐兩種藥24株，佔4.63％；耐三種及以上藥254株，佔49.03％。217株為耐多藥菌株，佔所有病例的41.89％。65株為廣汎耐藥菌株，佔所有病例的12.55％，佔耐多藥菌的29.95％。在一線藥物中，耐異煙肼有278株，耐藥率達53.67％；二線藥物中，耐氧氟沙星有206株，耐藥率達39.77％。433例複治患者任一藥物耐藥率、耐多藥率和廣汎耐藥率分彆為72.05％、46.42％和13.86％，均高于初治患者的44.70％、18.82％和5.88％（x2 =24.253，x2=22.229，x2=4.117，均P＜0.01）。結論 上海地區結覈病專科醫院結覈分枝桿菌分離株的耐藥率高，且耐多藥與廣汎耐藥率也較高，在複治患者中耐藥情況更嚴重。
목적 료해결핵분지간균분리주대일선화이선항결핵약물적내약성。방법 수집2008년1월지2009년3월채용Bactec-MGIT 960검측적518주결핵분지간균，분석약물민감시험결과。수거행x2검험。결과518주결핵분지간균균주대일선화이선항결핵약물전민감168주，점32.44％；내약350주，점67.56％;단내약72주，점13.90％；내량충약24주，점4.63％；내삼충급이상약254주，점49.03％。217주위내다약균주，점소유병례적41.89％。65주위엄범내약균주，점소유병례적12.55％，점내다약균적29.95％。재일선약물중，내이연정유278주，내약솔체53.67％；이선약물중，내양불사성유206주，내약솔체39.77％。433례복치환자임일약물내약솔、내다약솔화엄범내약솔분별위72.05％、46.42％화13.86％，균고우초치환자적44.70％、18.82％화5.88％（x2 =24.253，x2=22.229，x2=4.117，균P＜0.01）。결론 상해지구결핵병전과의원결핵분지간균분리주적내약솔고，차내다약여엄범내약솔야교고，재복치환자중내약정황경엄중。
Objective To investigate the resistant patterns of Mycobacterium tuberculosis (MTB) strains against first- and second-line anti-tuberculosis drugs. Methods Drug susceptibility tests of 518 MTB strains collected from January 2008 to March 2009 were performed using BactecMGIT 960. The data were analyzed by chi square test. Results In 518 strains, 168 (32.44％) were all sensitive to all seven drugs, 350 (67.56％) were resistant to at least one drug. Among all strains, 72 (13.90％) were resistant to one drug, 24 (4.63％) were resistant to two drugs, 254 (49.03％) were resistant to three or more drugs. A total of 217 strains (41.89 ％) were classified as multi-drug resistant tuberculosis (MDR-TB) strains and 65 (12.55％) were extensively drug resistant tuberculosis (XDR-TB) strains which accounted for 29.95 ％ of MDR-TB strains. The drug resistant rate of isoniazid which belonged to first-line drugs was 53.67％ (278 strains) and that of ofloxacin which belonged to second-line drugs was 39.77 ％ (206 strains). In 433 retreated patients, the drug resistant rate against any drugs, MDR rate and XDR rate were 72.05％, 46.42％ and 13.86％,respectively, which were all higher than those in treatment naive patients (44.70％, 18. 82％ and 5.88％, respectively; x2 = 24. 253, x2 ＝ 22. 229 and x2 ＝ 4. 117, respectively; all P ＜ 0.01).Conclusions The resistant rate of MTB is high in a tuberculosis specialized hospital in Shanghai, and MDR-TB also shares a high resistant rate as well as XDR-TB. Furthermore, drug resistance is more common in retreated patients.
