论文部分内容阅读
目的了解浙江省初始耐药结核病疫情现状和变化趋势,评价现行结核病控制策略的效果。方法按世界卫生组织《结核病耐药监测指南》(WHO/IUATLD)的要求对新登记初治涂阳肺结核病例进行耐药结核病监测,并与浙江省1998/1999年第1次耐药监测结果进行比较。结果30个监测点共入选结核病例936例,对834株结核分枝杆菌进行4种抗结核药物[链霉素(S)、异烟肼(H)、利福平(R)和乙胺丁醇(E)]的耐药性测定,初始耐药率为26.6%,初始耐多药率为3.7%。初治耐药病例中,65.8%仅对1种药物耐药,4种药物的耐药率顺位由高到低依次为:S(19.2%)、H(12.4%)、R(5.0%)、E(4.0%),对1种和2种及以上药物的初始耐药率分别为17.5%和9.0%。与1998/1999年相比,全省初始耐药率上升显著(χ2=34.606,P=0.000),耐多药率水平则呈现下降趋势,结核分枝杆菌耐药性发生更趋向于耐单一药。结论浙江省初始耐多药结核病情况虽有所改善,但初始耐药结核病疫情依然严峻,进一步提高结核病控制质量是当务之急。
Objective To understand the current situation and trend of the outbreak of initial drug-resistant TB in Zhejiang Province and evaluate the effect of the current TB control strategy. Methods The surveillance of drug-resistant tuberculosis (TB-TB) in newly registered smear-positive pulmonary tuberculosis patients was conducted according to the WHO guidelines for monitoring drug resistance (WHO / IUATLD) and the results of the first drug resistance surveillance in Zhejiang Province in 1998/1999 Compare Results A total of 936 TB cases were selected from 30 surveillance sites. Four anti-tuberculosis drugs (streptomycin, isoniazid, rifampicin and rivastigmine) were administered to 834 M. tuberculosis isolates, Alcohol (E)], the initial drug resistance rate was 26.6% and the initial multi-drug resistance rate was 3.7%. Among newly diagnosed drug-resistant cases, 65.8% were resistant to only one drug, and the order of resistance of the four drugs was S (19.2%), H (12.4%) and R (5.0% , E (4.0%). The initial drug resistance rates to 1, 2 and more drugs were 17.5% and 9.0%, respectively. Compared with 1998/1999, the initial drug resistance rate in the province increased significantly (χ2 = 34.606, P = 0.000), and the multi-drug resistance rate showed a downward trend. The drug resistance of M. tuberculosis tended to be more resistant to single drug . Conclusions Although the initial MDR-TB status in Zhejiang Province has been improved, the initial outbreak of drug-resistant TB remains severe, and it is imperative to further improve the quality of TB control.