【摘要】 目的分析反复多次治疗且治疗时间间隔≥2年的结核病患者结核分枝杆菌的耐药情况。方法回顾性分析2013年1月至2020年12月间苏州大学附属传染病医院收治的反复多次治疗且治疗时间间隔≥2年的44例结核病患者的资料,获得其基线及反复多次治疗后的耐药(包括利福平、异烟肼、阿米卡星、乙胺丁醇、莫西沙星、左氧氟沙星、对氨基水杨酸、丙硫异烟胺和链霉素)情况,并进行对比分析。结果 44例结核病患者基线菌株对利福平、异烟肼、阿米卡星、左氧氟沙星、对氨基水杨酸、链霉素的耐药率分别为20.5%(9/44)、31.8%(14/44)、22.7%(10/44)、7.9%(3/38)、5.4%(2/37)和3.1%(1/32),无乙胺丁醇、莫西沙星和丙硫异烟胺耐药菌株;经反复多次治疗后,患者对利福平、异烟肼、阿米卡星、乙胺丁醇、莫西沙星、左氧氟沙星、对氨基水杨酸、丙硫异烟胺和链霉素的耐药率分别为38.6%(17/44)、43.2%(19/44)、20.5%(9/44)、13.6%(6/44)、12.8%(5/39)、15.8%(6/38)、8.1%(3/37)、18.4%(7/38)和6.2%(2/32)。17例患者出现了耐药种类增多的现象,5例患者成为准广泛耐药结核病患者。结论结核分枝杆菌对药物的耐药率增高和耐药种类的增多与结核病的治疗史有关,在治疗过程中应密切关注结核分枝杆菌耐药的变化,合理规范使用抗结核药物。更多还原

【Abstract】 Objective To analyze the drug resistance of Mycobacterium tuberculosis in the patients who had tuberculosis and received repeated treatment with the treatment interval≥2 years. Methods A retrospective analysis method was used.The data and information of 44 tuberculosis patients,who were repeatedly treated with two years or more treatment interval in the Infectious Diseases Hospital Affiliated to Soochow University from January 2013 to December 2020 were collected.Their drug resistance situation(including rifampicin,isoniazid,amikacin,ethambutol,moxifloxacin,levofloxacin,p-aminosalicylic acid,prothionamide and streptomycin)at baseline and after received repeated treatment were compared and analyzed. Results The baseline drug resistance rates of rifampicin,isoniazid,amikacin,levofloxacin,p-aminosalicylic acid and streptomycin in those 44 tuberculosis patients were 20.5%(9/44),31.8%(14/44),22.7%(10/44),7.9%(3/38),5.4%(2/37)and 3.1%(1/32)respectively and there were no drug resistance strains to ethambutol,moxifloxacin and prothionamide;After received repeated treatment,the drug resistance rates of rifampicin,isoniazid,amikacin,ethambutol,moxifloxacin,levofloxacin,p-aminosalicylic acid,prothionamide and streptomycin in those patients were 38.6%(17/44),43.2%(19/44),20.5%(9/44),13.6%(6/44),12.8%(5/39),15.8%(6/38),8.1%(3/37),18.4%(7/38)and6.2%(2/32)respectively.The types of drug resistance increased in 17 patients.Five patients developed preextensive drug resistance. Conclusion The increased drug resistance rate of Mycobacterium tuberculosis and the increased types of drug resistance are related to the history of tuberculosis treatment.During the anti-tuberculosis treatment,the drug resistance should be closely paid attention and monitored,and the anti-tuberculosis drugs should be rationally used.更多还原