河北省五市结核分枝杆菌耐药情况及耐多药菌株对利奈唑胺的敏感性
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高会霞

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R181.3+2 R521

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河北省医学科研重点课题项目(20150155)


Drug resistance of Mycobacterium tuberculosis and susceptibility of multidrugresistant strains to linezolid in 5 cities in Hebei Province
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    摘要:

    目的了解河北省结核分枝杆菌耐药情况,以及耐多药结核分枝杆菌对利奈唑胺的敏感性,指导临床治疗耐多药结核病。方法收集河北省五市六所医院2016年1—12月974例结核病患者分离菌株及患者临床信息,检测结核分枝杆菌对抗结核药物异烟肼(INH)、利福平(RFP)、链霉素(SM)、乙胺丁醇(EMB)、氧氟沙星(OFX)、卡那霉素(KM)的敏感性,采用分层随机法选取100株耐多药结核分枝杆菌,检测其对利奈唑胺的敏感性。结果结核病初治患者的耐药率和耐多药率分别为26.6%(200/753)和13.5%(102/753),复治患者的耐药率和耐多药率分别为59.7%(132/221)和53.4(118/221),复治患者耐药率和耐多药率均高于初治患者(χ2值分别为83.7、93.5,均P<0.01)。一线抗结核药物INH、RFP、SM和EMB的耐药率分别为25.8%、23.7%、16.7%和7.1%;二线抗结核药物OFX和KM的耐药率为4.7%(37/782)和4.0%(31/782);耐多药结核分枝杆菌对利奈唑胺的敏感率为80.8%(59/73)。 结论结核病复治患者耐药率和耐多药率高于初治患者,利奈唑胺体外对耐多药结核分枝杆菌具有良好的抗菌活性。

    Abstract:

    ObjectiveTo understand the drug resistance of Mycobacterium tuberculosis(MTB) and susceptibility of multidrugresistant MTB (MDRMTB) to linezolid in Hebei Province, so as to guiding clinical treatment of MDR tuberculosis.MethodsThe isolated strains and clinical information of patients with tuberculosis in 6 hospitals of 5 cities in Hebei Province between January and December 2016 were collected, susceptibility of MTB to antituberculous drugs isoniazid (INH), rifampicin(RFP), streptomycin (SM), ethambutol(EMB), ofloxacin(OFX), and kanamycin(KM)were detected, 100 strains of MDRMTB were selected by stratified random sampling method, susceptibility to linezolid was detected.ResultsDrug resistance rate and MDR rate of the initially treated cases were 26.6%(200/753)and 13.5%(102/753) respectively, drug resistance rate and MDR rate of the retreatment cases were 59.7%(132/221)and 53.4(118/221)respectively, drug resistance rate and MDR rate of the retreatment cases were both statistically higher than initially treated cases(χ2=83.7,P<0.01; χ2=93.5,P<0.01). Resistance rates of MTB to firstline antituberculous drugs INH, RFP, SM, and EMB were 25.8%, 23.7%, 16.7%, and 7.1% respectively, to secondline antituberculous drugs OFX and KM were 4.7%(37/782)and 4.0%(31/782) respectively;susceptibility of MDRMTB to linezolid was 80.8% (59/73).ConclusionDrug resistance rate and MDR rate of the retreated tuberculosis patients are higher than initially treated patients, linezolid has good in vitro antimicrobial activity against MDRMTB.

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许怡,张志,田岳飏,等.河北省五市结核分枝杆菌耐药情况及耐多药菌株对利奈唑胺的敏感性[J]. 中国感染控制杂志,2018,17(3):191-195. DOI:10.3969/j. issn.1671-9638.2018.03.002.
XU Yi, ZHANG Zhi, TIAN Yueyang, et al. Drug resistance of Mycobacterium tuberculosis and susceptibility of multidrugresistant strains to linezolid in 5 cities in Hebei Province[J]. Chin J Infect Control, 2018,17(3):191-195. DOI:10.3969/j. issn.1671-9638.2018.03.002.

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  • 收稿日期:2017-07-28
  • 最后修改日期:2017-09-26
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  • 在线发布日期: 2018-03-28
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