南京地区2013-2014年结核分枝杆菌耐药流行情况调查

目的 了解南京地区胸科医院2013-2014年结核杆菌对药物的耐药情况.方法 使用绝对浓度法对本院2013、2014年获得的2510株抗酸分枝杆菌株进行耐药监测及对比研究;此外统计耐多药患者临床资料,了解耐多药肺结核与糖尿病的合并情况.结果 2013-2014年南京胸科医院RR-TB、Pre-XDR-TB耐二线药物发病率呈增长趋势.Pre-XDR-TB在MDR-TB构成比可达51%,且在Pre-XDR-TB中耐左氧氟沙星明显多于耐二线注射用药.结核菌对丁胺卡那霉素、卡那霉素、卷曲霉素三种药物的敏感、耐药性高度一致,其交叉耐药明显.耐药肺结核患者中糖尿病比例呈增长趋势.结论 南京地区胸科医院结核杆菌耐药率高,应加强抗结核药物耐药性监测、门诊随访、合并症分析,根据药敏试验结果选择科学有效的化疗方案.

Investigation of drug resistance of Mycobacterium tuberculosis in Nanjing Area during 2013 -2014

Objective To understand the resistance of tuberculosis to antibiotics in Nanjing during 2013-2014. Methods Absolute concentration method was used to investigate the tuberculosis strains during 2013-2014 for drug resistance. Moreover, the clinical data of patients with MDR-TB were analyzed, and the relationship between type 2 diabetes and MDR-TB were explored. Results The morbidity of RR-TBand pre-XDR-TB for second-line in-jectable drug resistance increased in recently years. Pre-XDR-TB in the proportions of MDR-TB reached over 51%respectively. Fluoroquinolones accounted for the vast majority in a proportion of Pre-XDR-TB. It had cross-resistance with amikacin, kanamycin and capreomycin. The proportion of diabetes mellitus in drug resistant tuberculosis patients increased in recently years. Conclusion The resistance rate of tuberculosis in Nanjing area is high. Monitoring of resistance to anti-tuberculosis drugs, follow-up of outpatient and analysis of complications must be strengthened. The reasonable and efficient therapy should be chosen based on anti-tuberculosis susceptibility test.