福建省耐药肺结核高危人群利福平耐药情况及其影响因素分析

目的 了解耐药肺结核高危人群利福平耐药情况及其影响因素,为制定适宜的结核病防治策略提供参考依据。 方法 通过中国疾病预防控制中心《结核病管理信息系统》获取2018年福建省登记的650例耐药肺结核高危人群相关信息,包括利福平耐药情况、患者年龄、性别、民族、职业、户籍及登记分类情况。分析耐药肺结核高危人群利福平耐药情况,并采用单因素和多因素logistic回归分析利福平耐药的影响因素。 结果 650例耐药肺结核高危人群中利福平耐药患者143例,耐药率为22.0%;单因素分析结果显示,年龄≥65岁、男性、本地户籍、职业为农民工及登记分类为其他的耐药肺结核高危人群利福平耐药率分别为12.2%(22/180)、20.1%(109/541)、17.8%(81/455)、18.4%(78/425)、6.2%(1/16),明显低于年龄<25岁46.2%(12/26)]、女性31.2%(34/109)]、外地户籍31.8%(62/195)]、职业为家政/家务/待业人员33.6%(42/125)]、登记分类为复治失败/慢性患者77.8%(7/9)]的耐药肺结核高危人群,差异均有统计学意义(χ ²值分别为21.57、6.45、15.58、13.15、54.80,P值均<0.05)。多因素logistic回归分析结果显示,年龄25~34岁和≥65岁以“<25岁”为参照,OR(95%CI)值分别为0.32(0.11~0.95)和0.24(0.09~0.65)]的耐药肺结核高危人群利福平耐药风险较低;外地户籍以“本地户籍”为参照,OR(95%CI)=1.87(1.19~2.93)]、职业为家政/家务/待业以“农民工”为参照,OR(95%CI)=2.01(1.21~3.34)]、登记分类为复发、初治失败、复治失败/慢性患者以“其他”为参照,OR(95%CI)值分别为10.90(1.34~88.68)、23.69(2.67~209.87)、133.89(9.50~1887.37)]的耐药肺结核高危人群利福平耐药风险较高。 结论 福建省耐药肺结核高危人群利福平耐药率较高。年龄<25岁,户籍为外地,职业为家政/家务/待业,登记分类为复发、初治失败及复治失败/慢性患者是耐药肺结核高危人群对利福平耐药的高危因素。

Prevalence and influencing factors of rifampicin resistance among high-risk group of drug-resistant tuberculosis in Fujian Province

Objective To understand the prevalence and influencing factors of rifampicin resistance (RR) in high-risk group of drug-resistant tuberculosis (TB) in Fujian Province and to provide references for the development of appropriate TB control strategies. Methods The information of 650 high-risk group of drug resistant TB registered in Fujian in 2018 was collected from the TB management information system of the Chinese Center for Disease Control and Prevention, including rifampicin resistance, age, gender, ethnicity, occupation, household registration, and registration classification. The prevalence of rifampicin resistance in high-risk group of drug-resistant TB was analyzed, and the influencing factors of RR in high-risk group were analyzed by univariate and multivariate logistic regression. Results Among 650 high-risk group of drug resistant TB, there were 143 cases of RR-TB, with a drug resistance rate of 22.0%. Univariate analysis showed that the RR rates of the high-risk groups with aged ≥65, male, local resident, occupation as migrant worker and registration classification as other were significantly lower than those with aged <25 (12.2% (22/180) <46.2% (12/26), χ ²=21.57, P<0.05), female (20.1% (109/541) <31.2% (34/109), χ ²=6.45, P<0.05), foreign household registration (17.8% (81/455) <31.8% (62/195), χ ²=15.58, P<0.05), occupation as housekeeping/housework/unemployed workers (18.4% (78/425) <33.6% (42/125), χ ²=13.15, P<0.05) and registration classification as retreatment failure/chronic patients (6.2% (1/16) <77.8% (7/9), χ ²=54.80, P<0.05), respectively. Multivariate logistic regression analysis showed that the risk of RR in the high-risk group with aged 25-34 and ≥65 (referenced as aged <25, OR (95%CI) were 0.32 (0.11-0.95), 0.24 (0.09-0.65)) was lower, while the risks of RR in the high-risk group with foreign household registration (referenced as local resident, OR (95%CI)=1.87 (1.19-2.93)), occupation as housekeeping/housework/unemployed workers (referenced as migrant worker, OR (95%CI)=2.01 (1.21-3.34)), and registration classification’s relapse, initial treatment failure and retreatment failure/chronic patients (referenced as other, OR (95%CI) were 10.90 (1.34-88.68), 23.69 (2.67-209.87) and 133.89 (9.50-1887.37)) were higher. Conclusion The RR rate in high-risk group of drug-resistant TB was high in Fujian. Aged <25, foreign household registration, occupation as housekeeping/housework/unemployed workers, and registration classification as relapse, initial treatment failure and retreatment failure/chronic patients were risk factors of RR in high-risk group of drug resistant TB.