【摘要】 目的 全面了解青岛市耐药结核病流行现状和特点,为制定和完善防控措施提供依据。方法 2012年1月1日至2012年12月31日,依据WHO和国际防痨和肺部疾病联合会(IUATLD)结核病耐药监测指南,收集青岛市2012年连续新发涂阳肺结核患者938例和同期新登记的复治涂阳肺结核患者42例,对成功分离的980例结核分牧杆菌菌株,采用比例法对利福平(R)、异烟肼(H)、链霉素(S)、乙胺丁醇(E)等4种药物进行药物敏感性试验。采用SPSS 18.0进行统计学分析,率的比较采用卡方检验,以P<0.05为差异有统计学意义。结果 2012年青岛市新发涂阳肺结核患者与复治涂阳肺结核患者的总耐药率为22.45%(220/980),初治患者耐药率为21.75%(204/938),复治患者耐药率为38.10%(16/42);总耐多药率为4.69%(46/980),初治患者耐多药率为4.05%(38/938),复治患者耐多药率为19.05%(8/42),复治患者耐多药率明显高于初治患者耐多药率(X~2=20.21,P<0.01)。结论 青岛市耐药疫情仍然较重,面临耐多药结核病的挑战,结核病耐药谱呈多态性和复杂性,需采取更全面、更积极的干预措施遏制耐药结核病疫情。更多还原

【Abstract】 Objective To understand the epidemic situation and characteristic of drug resistant tuberculosis(DR-TB)in Qingdao and to provide scientific evidence for the development and improvement of TB control strategies.Methods According to the anti-TB drug resistance guidelines issued by WHO/IUALD,938 new smear positive cases and 42 new registered retreatment smear positive cases in 2012 were included in the surveillance.A total of 980 strains of Mycobacterium tuberculosis were isolated and proportion method were applied in drug susceptibility test(DST)for rifampicin(R),isoniazid(H),streptomycin(S)and ethambutol(E).,chi-square was used for frequencies comparison.Statistical analyses were performed using SPSS(Statistical Package for Social Sciences,USA),version 18.0.P<0.05 was considered statistically significant.Results The overall drug resistance rate was 22.45%(220/980),21.75%(204/938) and 38.10%(16/42)for initial and acquired drug resistance respectively.The total multidrug resistance(MDR) rate was 4.69%(46/980),4.05%(38/938) and 19.05%(8/42) respectively for initial and acquired multidrug resistance.The rate of acquired multidrug resistance was significantly higher than initial multidrug resistance(X~2=20.21,P<0.01).Conclusion The TB burden especially MDR-TB is still very serious in Qingdao.TB drug resistance spectrum is diversity and complexity,we need to adopt more comprehensive,more active intervention measures to curb the epidemic of drug-resistant tuberculosis.更多还原