【摘要】 目的 分析北京市结核病防治机构(简称“结防机构”)和结核病定点医院疑似耐多药肺结核患者的耐药状况,为耐多药肺结核的临床诊断、治疗和防控工作提供参考。方法 采用回顾性调查方法,对2014年1月至2016年12月北京市14家结核病防治机构和6家定点医院收治的881例疑似耐多药肺结核患者痰培养阳性的临床分离株进行初步菌种鉴定和药物敏感性试验(简称“药敏试验”)(INH、RFP、Sm、EMB、Lfx、Am、Cm、Pto、PAS),耐药患者对各种抗结核药物的耐药情况采用SPSS 17.0统计软件进行统计分析;并分析、归纳北京市3年间疑似耐多药肺结核患者的耐药情况。结果 881例疑似耐多药肺结核患者菌株中,分离出结核分枝杆菌复合群占88.6%(781/881),非结核分枝杆菌群占11.4%(100/881)。结核分枝杆菌复合群临床分离株的总耐药率为33.3%(260/781),耐多药率为17.2%(134/781);耐药菌株药敏试验显示对4种一线抗结核药物(INH、RFP、Sm、EMB)的高耐药百分比(>67.0%)分别为69.0%(127/184)、57.1%(92/161)、60.5%(107/177)、31.7%(19/60)。结论 对北京市疑似耐多药肺结核患者进行药敏试验非常必要,北京市面临的耐药结核病疫情仍十分严峻。更多还原

【Abstract】 Objective To analyze the drug resistance situation of patients with suspected multidrug-resistant pulmonary tuberculosis(MDR-PTB) in TB control institutes and TB designated hospitals in Beijing, to provide suggestions for clinical diagnosis, treatment, and control. Methods We made a retrospective analysis, including preliminary bacteria identification and drug susceptibility testing of the bacteria isolated from the positive sputum specimens of the 881 suspected MDR-PTB patients from 14 TB control institutes and 6 TB designated hospitals in Beijing between January 2014 and December 2016. We collected their drug susceptibility testing results against INH, RFP, Sm, EMB, Lfx, Am, Cm, Pto, and PAS. SPSS 17. 0 was used for statistical analysis. We analyzed and summarized the drug resistance situation of suspected MDR-PTB patients in those 3 years. Results In the 881 suspected MDR-PTB patients, the isolation rate of Mycobacterium tuberculosis complex group was 88. 6%(781/881).The isolation rate of non-tuberculous mycobacterium(NTM) was 11. 4%(100/881). The total drug resistant rate of the clinical isolates of Myobacterium tuberculosis complex group was 33. 3%(260/781). The multidrug-resistance(MDR) rate was 17. 2%(134/781). The proportion of high-level of resistance rates(defined as >67. 0%) against the four first-line TB drugs(INH, RFP, Sm and EMB) was 69.0%(127/184), 57.1%(92/161), 60.5%(107/177) and 31.7%(19/60) respectively. Conclusion It is very necessary to carry out a drug sensitive test for the suspected MDR-PTB patients in Beijing, and the epidemic situation of TB resistance faced in Beijing is still very severe.更多还原