| 李静,张阳奕,桂晓虹,袁政安,潘启超,梅建,沈鑫.上海市耐多药结核病患者二线药物耐药情况及危险因素分析[J].Chinese journal of Epidemiology,2012,33(8):795-798 |
| 上海市耐多药结核病患者二线药物耐药情况及危险因素分析 |
| Prevalence and risk factors an the reststane related to second-line drugs among multi—drug resistant tuberculosis Csses In Shanghm.China |
| Received:January 31, 2012 |
| DOI： |
| KeyWord: 耐多药结核病 危险因素 |
| English Key Word: Multidrug resistant tuberculosis Risk factors |
| FundProject:上海市科学技术委员会基金（1IZRl430900.IOJCl413700）；上海市卫生系统优秀青年人才培养计捌（XYQ2011051）；“十一五”国家科技重大专项（2009Z.X10003-017] |
| Author Name | Affiliation | E-mail | | LI Jing | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | | | ZHANG Yangyi | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | | | GUI Xiaohong | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | | | YUAN Zhengan | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | | | PAN Qichao | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | | | MEI Jian | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | meijiansh@yahoo.com.cn | | SHEN Xin | Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China | xshen@scddc.sh.cn |
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| Abstract: |
| 目的 分析上海市耐多药结核病（MDR-TB）患者二线药物耐药分布情况及危险因素。方法 收集2009年上海市各区（县）结核病定点医院痰培养阳性菌株，进行菌型鉴定和一线抗结核药物（异烟肼、利福平、链霉素及乙胺丁醇）敏感性检测，对耐多药菌株进行二线抗结核药物（卡那霉素、阿米卡星、卷曲霉素、氧氟沙星、对氨基水杨酸及丙硫异烟胺）敏感性检测，结合患者特征及实验室信息，采用多因素分析上海市MDR-TB患者二线药物耐药的危险因素。结果 2009年上海市确诊的1867例结核病病例中，112例（6.0%）为MDR-TB患者，其中58例（51，8%）至少耐1种二线抗结核药物，10例为广泛耐药结核病。多因素分析显示，MDR-TB患者中，45~59岁年龄组（aOR=4.76，P=0.001）及痰涂片阳性（aOR=6.51，P=0.026）与二线药物耐药相关。结论 上海市MDR-TB患者二线抗结核药物耐药情况严重，45~59岁年龄组和痰涂片阳性是MDR-TB患者二线药物耐药相关的危险因素。 |
| English Abstract: |
| Objective To determine the prevalence and risk factors on second-line drug resistance in patients with multidrug resistant tuberculosis（MDR-TB) in Shanghai,China.Methods All pulmonary TB patients with sputum culture positivity detected in Shanghai during January to December,2009,were enrolled.All of the pretreatment sputum-positive cultures samples were tested for routine specimen identification and routine drug susceptibility testing for first-line drugs（Isoniazid,Rrifampin,Ethambutol and Streptomycin).Drug susceptibility testing on second-line anti-TB drugs（Ofloxcin,Amikacin,Kanamycin,Capreomycin,P-aminosalicylic acid and Prothionamide) was routinely performed on isolates of Mycobacterium（M.) TB with MDR.Logistic regression analysis was conducted to determine the risk factors regarding second-line drug resistance.Results A total of 1867 patients infected with M.TB isolates were diagnosed at the TB hospitals/clinics in Shanghai during the study period,of whom 112（6.0％) were MDR-TB,in which 58 cases（51.8％) showed resistant to at least one of the second-line drugs tested and 10 cases belonged to extensively drug-resistant.In the multivariate analyses,MDR-TB patients who were aged 45-59 years（aOR=4.76,P=0.001),with sputum smear positivity（aOR=6.51,P=0.026) were significantly more likely to show resistance to second-line drugs.Conclusion The prevalence of second-line drug resistance among MDR-TB patients was high in Shanghai.MDR-TB patients who were under age of 45-59 years and with sputum smear positivity would represent important common risk factors for the resistance to second-line drugs. |
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