结核与肺部疾病杂志2024，Vol.5Issue(5)：437-444,8.DOI:10.19983/j.issn.2096-8493.2024124
2021-2023年内蒙古自治区兴安盟结核分枝杆菌耐药特征及耐多药影响因素分析
Analysis of features of drug resistance of Mycobacterium tuberculosis and risk factors of multidrug-resistance in Hinggan League of Inner Mongolia Autonomous Region,2021-2023
摘要
Abstract
Objective:To analyze the drug resistance of Mycobacterium tuberculosis and risk factors of multidrug-resistance in Hinggan League,Inner Mongolia from 2021 to 2023,and provide scientific evidence for preventing the occurrence and prevalence of drug-resistant tuberculosis in Hinggan League.Methods:The registration information of 615 culture positive patients in six counties(banners)of Hinggan League from January 1st,2021 to December 30th,2023 were collected from China National Notifiable Infectious Disease Reporting Information System,and the drug susceptibility tests of 615 strains of Mycobacterium tuberculosis to 16 anti-tuberculosis drugs were carried out using the microplate method and the influencing factors of multi-drug resistance of tuberculosis patients were analyzed using the logistic regression model.Results:(1)The drug susceptibility test results showed that the higher resistance rates to 16 anti-tuberculosis drugs were INH(13.01％,80/615),Sm(11.71％,72/615),Km(6.99％,43/615),Cs(6.18％,38/615),and RFP(5.37％,33/615).There were statistically significant differences in the resistance rates of RFP,Km,Rfb,PAS,and PAS-INH(4.22％(20/474)and 9.22％(13/141),5.49％(26/474)and 12.06％(17/141),1.05％(5/474)and 4.26％(6/141),1.69％(8/474)and 5.67％(8/141),1.05％(5/474)and 4.26％(6/141))between initial and retreatment patients(x2=5.351,P=0.021;x2=7.217,P=0.007;x2=4.646,P=0.031;x2=5.332,P=0.021;x2=4.646,P=0.031).(2)There were 198 drug-resistant strains among 615 strains,with a overall drug resistance rate of 32.20％(198/615),RFP resistance rate of 2.28％(14/615),Mono-drug resistance rate of 20.33％(125/615),poly-resistance rate of 8.78％(54/615),multidrug-resistance rate of 3.09％(19/615).The drug resistance spectrum of the sixteen anti-tuberculosis drugs consisted of 46 different types of drug resistance,including 9 types of mono-drug resistance,24 types of poly-resistance,9 types of multidrug-resistance(not including pre-extensive drug resistance),and 4 types of extensive drug resistance.The poly-resistance rate(15.60％,22/141)in retreatment patients was higher than that in initial patients(6.75％,32/474)(x2=10.631,P=0.001).(3)Retreated tuberculosis patients and key populations were risk factors for MDR-TB(OR=3.232,95％CI:1.187-8.805;OR=3.388,95％CI:1.211-9.479),and direct medical treatment was a protective effect against MDR-TB(OR=0.196,95％CI:0.043-0.885).Conclusion:From 2021 to 2023,the drug resistance spectrum presented complexity and diversity in Hinggan League.The treatment history,whether it was a key population,and the source of patients were the influencing factors of drug resistance.关键词
分枝杆菌,结核/结核,抗多种药物性/因素分析,统计学/兴安盟Key words
Mycobacterium tuberculosis/Tuberculosis,multidrug-resistant/Factor analysis,statistical/Hinggan League分类
医药卫生引用本文复制引用
孙博,欧喜超,冯丽平,滕冲,朱含芳,赵冰,冯涛,王庆奎,周浩,高星海..2021-2023年内蒙古自治区兴安盟结核分枝杆菌耐药特征及耐多药影响因素分析[J].结核与肺部疾病杂志,2024,5(5):437-444,8.基金项目
内蒙古自治区科技创新引导项目(2022003) Inner Mongolia Autonomous Region Science and Technology Innovation Guidance Project(2022003) （2022003）
