目的了解上海市静安区结核病传播特征及结核分枝杆菌耐药情况,为制定有针对性的结核病控制策略提供依据。方法选择上海市疾病预防控制中心菌株库保存的2010-2014年静安区结核病患者菌株,通过药物敏感性试验和可变数目串联重复序列分型,最后纳入70株菌株进行耐药、VNTR基因型分型结果分析。结果总耐药率为30.00%(21/70),总耐多药率为15.71%(11/70),单耐药率为12.86%(9/70),多耐药率为1.43%(1/70)。无单耐利福平和单耐乙胺丁醇。初治与复治患者、男性与女性患者、<65岁与≥65岁患者耐药率和耐多药率差异无统计学意义(P>0.05)。70株菌株共得到57种VNTR基因型,其中50例患者的分离株为单一基因型,其他20例患者的菌株可归入7个基因簇,总成簇率为28.57%(20/70),同簇病例中有2簇存在家庭内接触,有5簇居住地间的直线距离在1.7km以内。耐多药菌株成簇率高于全敏感结核菌株(χ~2=9.406,P=0.004),差异有统计学意义。结论上海市静安区结核分枝杆菌的耐多药率较高,结核病患者中存在一定比例的近期传播,耐多药肺结核近期传播程度较高,高于全敏感结核。 Objective To understand the transmission characteristics of tuberculosis and the drug resistance of Mycobacterium tuberculosis in Jing’an District of Shanghai and to provide a basis for the development of targeted tuberculosis control strategies. Methods The strains of patients with tuberculosis in Jingan District from 2010 to 2014, which were stored in the strain database of Shanghai Center for Disease Control and Prevention, were selected and drug susceptibility test and variable number of tandem repeat typing were performed. Finally, 70 strains were resistant to the drug. VNTR genotype Type result analysis. Results The total drug resistance rate was 30.00% (21/70), the total multidrug resistance rate was 15.71% (11/70), the single drug resistance rate was 12.86% (9/70) and the multidrug resistance rate was 1.43% (1 / 70). No single-resistant rifampicin and single-resistant ethambutol. There was no significant difference in the rates of drug resistance and multidrug resistance between patients with initial treatment and retreatment, male and female patients <65 and ≥65 years of age (P> 0.05). Of the 70 isolates, 57 VNTR genotypes were obtained, of which 50 isolates were single genotypes and the other 20 isolates belonged to 7 gene clusters with a total cluster rate of 28.57% (20/70) There are two clusters in the cluster with family contacts within the family, with a straight line distance of less than 1.7km between 5 clusters. The clustering rate of multidrug-resistant strains was higher than that of fully susceptible TB strains (χ ~ 2 = 9.406, P = 0.004), the difference was statistically significant. Conclusion Mycobacterium tuberculosis in Jingan District, Shanghai has a higher MDR-resistance rate, a certain proportion of tuberculosis patients have recently been transmitted, and the recent spread of multidrug-resistant tuberculosis is higher than that of fully sensitive TB.