2009年上海市耐药肺结核患者二线抗结核药物耐药状况调
查
沈鑫;李静;高谦;徐飚;梅建
【期刊名称】《中华结核和呼吸杂志》 【年(卷),期】2011(034)006
【摘要】目的 了解上海地区耐药结核病患者二线抗结核药物的耐药现状,为制定耐药结核病控制策略提供依据.方法 对上海市各区(县)结核病定点医院2009年1-12月诊治的肺结核患者4380例的痰培养阳性菌株,进行常规菌种鉴定和一线抗结核药物敏感性检测,对其中耐药肺结核患者431例进行二线抗结核药物敏感性检测.结果 431例耐药肺结核患者中120例(27.8%)对6种二线抗结核药物中任何一种具有耐药性,其中耐药率最高为氧氟沙星(68/431,15.8%),注射类药物中耐药率最高为卡那霉素(37/431,8.6%),其次为卷曲霉素(28/431,6.5%)和阿米卡星(23/431,5.3%),对氨基水杨酸钠的耐药率为8.1%(35/431),丙硫异烟胺的耐药率最低(8/431,1.9%).二线抗结核药物的耐药类型以单药耐药为主,耐利福平、耐异烟肼、其他耐药和耐多药组单药耐药例数分别为2/2、20/36、22/24和43/58例.结论 上海地区耐药肺结核患者对二线抗结核药物的耐药率较高,提示在常规检测一线抗结核药物敏感性的基础上,应开展二线抗结核药物敏感性检测,以早期发现耐药肺结核患者并给予合理治疗.%Objective To determine the pattern of resistance to second-line drugs(SLDs) in patients with tuberculosis(TB) in Shanghai, China. Methods All sputum culture positive patients detected at each district/county TB hospital/clinic in Shanghai during January to December 2009 were enrolled. First-line
drug susceptibility testing was routinely performed for each clinical isolate. All clinical isolates with any resistance to first-line anti-TB drug were tested for second-line drug susceptibility. Results Of the 431 TB patients with any resistance to first-line anti-TB drugs included in this study, 27.8%(120/431) were resistant to any SLDs tested. The rank of drug resistance was as follows: ofloxacin(68/431, 15.8%) > kanamycin(37/431, 8.6%) > para-aminosalicylic acid(35/431, 8.1%) > capreomycin(28/431,
6.5%)
>
amikacin(23/431,
5.3%)
>
prothionamide(8/431, 1.9%). Mono-resistance to SLD was the most predominant pattern. Among patients with resistance to SLD, the percentages of mono-resistance were 2/2, 20/36, 22/24 and 43/58 for rifampin-resistant group, isoniazid-resistant group, other-resistant group, and MDR group, respectively. Conclusion The high prevalence of resistance to SLDs in TB patients suggests the necessity to strengthen the TB control program for drug-resistant TB in Shanghai. 【总页数】3页(451-453)
【关键词】结核,肺;抗药性;抗药性,多药 【作者】沈鑫;李静;高谦;徐飚;梅建
【作者单位】200336,上海市疾病预防控制中心结核病防治科;200336,上海市疾病预防控制中心结核病防治科;复旦大学上海医学院医学分子病毒学重点实验室;复旦大学公共卫生学院流行病学教研室;200336上海市疾病预防控制中心结核病防治科
【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-tuberculosis-respiratory-diseases_thesis/0201232379381.html 【相关文献】
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2009年上海市耐药肺结核患者二线抗结核药物耐药状况调查
