青海省236株结核分枝杆菌耐药现状研究
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摘要
目的通过对青海地区236株结核分枝杆菌(mycobacterium tuberculosis,M.tb)进行分离培养与耐药性检测,了解青海地区结核病(tuberculosis,TB)的耐药现状,为青海地区结核病防治提供参考依据。方法对青海地区分离的236株结核分枝杆菌用改良罗氏培养基进行培养,采用比例法进行耐药性检测,分析该地区结核病耐药状况与人口学特征的关系,并对结果进行统计分析。结果 236株结核分枝杆菌总耐药率为55.93%(132/236);四种一线药物耐药率由高到低依次是异烟肼(isoniazid,INH)为43.22%,链霉素(streptomycin,SM)为38.14%,利福平(rifampin,RFP)为37.29%,乙胺丁醇(ethambutol,EMB)为28.81%;单耐药结核病(single drug resistance tuberculosis,SDR-TB)比例为12.71%;耐多药结核病(multidrug resistant tuberculosis,MDR-TB)和广泛耐药结核病(extensivelydrug resistant tuberculosis,XDR-TB)所占比例分别是30.93%(73/236)和1.27%(3/236);青海地区的结核分枝杆菌耐药状况与地区和年龄有关(均有P<0.05),与性别和民族无关(均有P>0.05)。结论青海地区耐药结核病比率高于全国水平,要加强该地区结核病的预防控制,对结核病患者进行规范化治疗。
Objective Through 236 strains of mycobacterium tuberculosis( M. tb) insolation and cultivation to explore drug resistance situation of mycobacterium tuberculosis which circulating in Qinghai area,so as to provide reference for TB prevention and control in this area. Methods A total of 236 strains of mycobacterium tuberculosis isolated in Qinghai were cultured with L-J medium. Drug resistance was tested by using the proportional method. The relationship between TB drug resistance and the demographic characteristics were analyzed. Results The results showed that drug resistance rate of 236 mycobacterium tuberculosis was 55. 93%( 132/236). Resistance rates of four first-line drugs from high to low were 43. 22% for isoniazid,38. 14% for streptomycin,37. 29% for rifampin and 28. 81% for ethambutol. MDR-TB and XDR-TB were 30. 93%( 73/236) and 1. 27%( 3/236) respectively. The ratio of SDR-TB was 12. 71%. This drug-resistance TB were associated with regions and ages( all P < 0. 05),but were not associated with gender and ethnicity( all P >0. 05). Conclusions The drug-resistance TB of Qinghai is higher than the national level. Measures of prevention and standardized treatment of tuberculosis patients should be strengthened in this area.
Objective Through 236 strains of mycobacterium tuberculosis( M. tb) insolation and cultivation to explore drug resistance situation of mycobacterium tuberculosis which circulating in Qinghai area,so as to provide reference for TB prevention and control in this area. Methods A total of 236 strains of mycobacterium tuberculosis isolated in Qinghai were cultured with L-J medium. Drug resistance was tested by using the proportional method. The relationship between TB drug resistance and the demographic characteristics were analyzed. Results The results showed that drug resistance rate of 236 mycobacterium tuberculosis was 55. 93%( 132/236). Resistance rates of four first-line drugs from high to low were 43. 22% for isoniazid,38. 14% for streptomycin,37. 29% for rifampin and 28. 81% for ethambutol. MDR-TB and XDR-TB were 30. 93%( 73/236) and 1. 27%( 3/236) respectively. The ratio of SDR-TB was 12. 71%. This drug-resistance TB were associated with regions and ages( all P < 0. 05),but were not associated with gender and ethnicity( all P >0. 05). Conclusions The drug-resistance TB of Qinghai is higher than the national level. Measures of prevention and standardized treatment of tuberculosis patients should be strengthened in this area.
引文
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[7]李斌,文飞,刘寿,等.RD105缺失基因检测法用于青海省北京/W系结核分枝杆菌鉴定[J].广州医药,2015,46(5):11-14.
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[11]杨娟,央拉,巴桑琼达,等.西藏拉萨地区198株结核分枝杆菌耐药性分析[J].西藏大学学报(自然科学版),2014,29(1):36-39.
[12]党丽云,魏香兰,方如塘,等.4 721例住院肺结核患者耐药状况及危险因素分析[J].中国防痨杂志,2014,36(1):49-54.
[13]Chuang PH,Wu MH,Fan SY,et al.Population-based drug resistance surveillance of multidrug-resistant tuberculosis in Taiwan,2007-2014[J].PLo S One,2016,11(11):e0165222.
[14]余述凤,梅晓冬,阚晓宏,等.安徽省耐多药肺结核危险因素病例对照研究[J].中华疾病控制杂志,2016,20(10):1026-1028.
[15]Zhao Y,Xu S,Wang L,et al.National survey of drug-resistant tuberculosis in China[J].N Engl J Med,2012,366(23):2161-2170.
[16]陆伟,周扬,陈诚,等.江苏省社区人群结核杆菌耐药状况及影响因素研究[J].中华疾病控制杂志,2013,17(7):560-563.
[17]梁军,文国颖.青海农牧民结核病知识、信念、行为的现况调查[J].河南预防医学杂志,2014,25(3):207-209.
[18]汤莉,邹铮,王纪祥,等.2008-2014年安徽省非结防机构肺结核患者转诊与追踪情况分析[J].中华疾病控制杂志,2016,20(3):299-302.
[2]王黎霞,成诗明,陈明亭,等.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[3]van Soolingen D,Qian L,de Haas PE,et al.Predominance of a single genotype of mycobacterium tuberculosis in countries of east Asia[J].J Clin Microbiol,1995,33(12):3234-3238.
[4]杨本付,徐飚.结核分枝杆菌W-北京家族菌株研究进展[J].中华流行病学杂志,2004,25(2):178-180.
[5]Dong H,Shi L,Zhao X,et al.Genetic diversity of mycobacterium tuberculosis isolates from Tibetans in Tibet,China[J].PLo SOne,2012,7(3):e33904.
[6]Hu Y,Mathema B,Zhao Q,et al.Comparison of the socio-demographic and clinical features of pulmonary TB patients infected with sub-lineages within the W-Beijing and non-Beijing mycobacterium tuberculosis[J].Tuberculosis(Edinb),2016,97:18-25.
[7]李斌,文飞,刘寿,等.RD105缺失基因检测法用于青海省北京/W系结核分枝杆菌鉴定[J].广州医药,2015,46(5):11-14.
[8]林萍,潘洁茹,林建,等.长乐市结核分枝杆菌耐药情况分析[J].中国卫生检验杂志,2012,22(12):3011-3013.
[9]曹红艳,吴长东,米利古,等.结核分枝杆菌新疆临床分离株耐药情况调查[J].中国病原生物学杂志,2010,5(4):253-255.
[10]Qiao L,Zhu L,Yan S,et al.Rates and risk factors for drug resistance tuberculosis in Northeastern China[J].BMC Public Health,2013,13(1):1-7.
[11]杨娟,央拉,巴桑琼达,等.西藏拉萨地区198株结核分枝杆菌耐药性分析[J].西藏大学学报(自然科学版),2014,29(1):36-39.
[12]党丽云,魏香兰,方如塘,等.4 721例住院肺结核患者耐药状况及危险因素分析[J].中国防痨杂志,2014,36(1):49-54.
[13]Chuang PH,Wu MH,Fan SY,et al.Population-based drug resistance surveillance of multidrug-resistant tuberculosis in Taiwan,2007-2014[J].PLo S One,2016,11(11):e0165222.
[14]余述凤,梅晓冬,阚晓宏,等.安徽省耐多药肺结核危险因素病例对照研究[J].中华疾病控制杂志,2016,20(10):1026-1028.
[15]Zhao Y,Xu S,Wang L,et al.National survey of drug-resistant tuberculosis in China[J].N Engl J Med,2012,366(23):2161-2170.
[16]陆伟,周扬,陈诚,等.江苏省社区人群结核杆菌耐药状况及影响因素研究[J].中华疾病控制杂志,2013,17(7):560-563.
[17]梁军,文国颖.青海农牧民结核病知识、信念、行为的现况调查[J].河南预防医学杂志,2014,25(3):207-209.
[18]汤莉,邹铮,王纪祥,等.2008-2014年安徽省非结防机构肺结核患者转诊与追踪情况分析[J].中华疾病控制杂志,2016,20(3):299-302.
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