【作者】 孔伟利； 孟令俊； 白大鹏； 李志媛； 李丽；

【Author】 Kong Weili,Meng Lingjun,Bai Dapeng,Li Zhiyuan,Li Li

【机构】 天津医科大学研究生院； 天津市海河医院结核科检验科；

【摘要】 目的了解菌阳肺结核病人对氟喹诺酮药物的耐药现状,评估用药时间与耐药产生的关系,为临床制定标准化方案提供参考依据。方法选取2008年3月至2009年3月期间天津市海河医院门诊及住院菌阳结核病患者119例,对其MTB临床分离株做药敏试验。结果初治患者耐药率OFLX14.5%,LVFX4.3%;复治患者耐药率OFLX60%,LVFX 44%;敏感菌OFLX耐药率19%,LVFX9.5%,耐药菌OFLX耐药率68.6%,LVFX48.6%;严重耐多药、耐多药、多耐药、单耐药OFLX耐药率分别、为83.3%、77.8%、66.7%、40%,LVFX66.7%、55.6%、40%、40%;氟喹诺酮用药时间≤2周2周～1月、1月～3月、3月～6月、≥6月,OFLX耐药率分别为33.3%、36.4%、50%、100%、100%;LVFX分别为16.7%、18.2%、42.9%、66.7%、100%。结论复治结核病对氟喹诺酮的耐药率较高,耐药结核菌对氟喹诺酮耐药率也明显高于敏感菌,而严重耐多药及耐多药菌株耐药率明显高于其他耐药类型结核病。试管内耐药浓度与耐药率呈负相关。制定标准方案时LVFX优于OFLX。更多还原

【Abstract】 Objective To investigate the resistant situation of fluoro-quinolones to mycobacterium tuberculosis isolated from sputum of patients with pulmonary tuberculosis and provide scientific for utilizing fluoroquinolones in antituberculosis regimen.Methods All strains isolated from patients hospitalized in Tianjin Haihe Hospital form March 2008 to March 2009 were conducted to strain identification and drug susceptibility tests with Ofloxacin,Levofloxacin.Results The resistance rates of initial treatment group were OFLX14.5%, LVFX 4.3%;and in the retreatment group were OFLX60%,LVFX 44%.The resistance rates of sensitive strains group were OFLX19%,LVFX 9.5%;and in the resistant strains group were OFLX68.6%,LVFX 48.6%.OFLX resistant rates in the Extensive Drug Resistant Tuberculosis,Multidrug-resistant Tuberculosis,polyresistance tuberculosis,Monoresistance tuberculosis were 83.3%、77.8%、66.7%、40%,LVFX resistant rates were 66.7%、55.6%、40%、40%.Fluoroquinolones have been used≤2week,2week～1month,1month～3month,3month～6month,≥6month,the OFLX resistant rates were 33.3%、36.4%、50%、100%、100%,LVFX resistant rates were 16.7%、18.2%、42.9%、66.7%、100%.Conclusions The fluoroquinolones resistance rate in the retreatment group,resistant strains group especially Extensive Drug Resistant Tuberculosis and Multidrug-resistant Tuberculosis were much higher than that in the other group.Vitro drug concentration was negatively correlated with drug resistance.LVFX is better than OFLX in chemotherapy.更多还原