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目的分析新疆博尔塔拉蒙古自治州(简称:博州)187例肺结核患者分离株耐药特征,为制定和完善博州结核病的防治措施提供科学依据。方法收集2013年3月1日至2014年2月28日博州三县市结核病门诊及住院部就诊的2 339例疑似肺结核病患者痰标本,进行痰涂片、培养及菌种鉴定,获得187株结核分枝杆菌,用比例法进行8种抗结核药物敏感性试验。采用卡方检验对药敏结果进行分析,以P<0.05为差异有统计学意义。结果 187例患者总耐药率为26.20%(49/187),总耐多药率为7.49%(14/187),其中初、复治患者耐药和耐多药率分别为23.98%(41/171)、50.00%(8/16)和5.85%(10/171)、25.00%(4/16)(χ2=5.12;7.75,P<0.05),差异具有统计学意义。8种药物有5种药物出现耐药,共出现了13种耐药形式,利福平耐药率为10.16%(19/187),19株利福平耐药株中14株为耐多药,耐多药占比73.68%(14/19),4种二线药物只有氧氟沙星耐药,耐药率为4.81%(9/187)。结论博州结核病耐药及耐多药疫情较重,复治患者耐药风险高,耐药谱广泛,利福平耐药率高,应加强患者的治疗管理,加强利福平耐药快速检测。
Objective To analyze the drug resistance characteristics of 187 pulmonary tuberculosis patients in Xinjiang Bortala Mongol Autonomous Prefecture (abbreviation: Bozhou), and to provide a scientific basis for the formulation and improvement of the prevention and treatment measures for tuberculosis in Bozhou. Methods A total of 2 339 suspected sputum samples of tuberculosis patients were collected from the TB clinics and inpatient departments of the three counties in Bazhou from March 1, 2013 to February 28, 2014. Sputum samples, culture and strain identification were collected and 187 Strain Mycobacterium tuberculosis, using the proportion of eight kinds of anti-TB drug sensitivity test. The chi-square test was used to analyze the drug susceptibility results, with P <0.05 as the difference was statistically significant. Results The total resistance rate of 187 patients was 26.20% (49/187) and the total multidrug resistance rate was 7.49% (14/187). The rates of multidrug resistance and multidrug resistance were 23.98% /171)50.00% (8/16), 5.85% (10/171), 25.00% (4/16) respectively (χ2 = 5.12; 7.75, P <0.05). Among the 8 drugs, 5 kinds of drugs showed resistance, 13 kinds of drug-resistant forms appeared, the resistance rate of rifampicin was 10.16% (19/187), 14 strains of 19 rifampin-resistant strains were multidrug-resistant (73.68%, 14/19). Only 4 of the 2 second-line drugs were ofloxacin-resistant, with a resistance rate of 4.81% (9/187). Conclusion The prevalence of multidrug-resistant and multidrug-resistant TB in Bozhou is high. The risk of drug resistance is high in broad-spectrum patients, and the spectrum of drug resistance is broad. The rate of rifampin-resistant drug is high. Treatment management should be strengthened and rapid testing of rifampin- .