中国人兽共患病学报2025，Vol.41Issue(10)：1040-1047,8.DOI:10.3969/j.issn.1002-2694.2025.00.170
2024年湖南某结核病定点医院结核病流行病学和耐药特征分析
Tuberculosis epidemiology and drug resistance characteristics in a designated tuberculosis hospital in Hunan Province in 2024
摘要
Abstract
This study was aimed at analyzing the epidemiological and drug resistance characteristics of tuberculosis at a desig-nated tuberculosis hospital in Hunan Province in 2024.Patients diagnosed with TB at the hospital between April and October 2024 were included in the study.Demographic data,clinical information,and drug sensitivity test results were collected from the hospital′s electronic medical record system.Descriptive statistics,the chi-square test,and logistic regression were used to analyze the epidemic characteristics,drug resistance characteristics,and factors influencing tuberculosis.Whole genome sequencing of isolates was per-formed,and lineage classification and drug resistance gene mutations were detected with TB-Profiler.The male-to-female ratio was 2.72∶1,and the median age was 56(IQR:43-66)years.Among the 391 patients,most were farmers(46.8%,183/391)and were pri-marily from Changsha(41.1%,162/391).Significant differences were observed in sex and occupation between pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB).The overall prevalence of any type of drug resistance of tuberculosis was 33.25%,and the multidrug resistance TB(MDR-TB)and poly-drug resistance(PR-TB)rates were 14.23%and 4.35%,respectively.The re-sistance rates to rifampicin(RIF),isoniazid(INH),ethambutol(EMB),and streptomycin(SM)were 17.90%,22.25%,6.39%,and 20.20%,respectively.Multivariable logistic regression analysis indicated that both diabetes(OR:2.295,95%CI:1.082-4.866)and retreatment(OR:17.822,95%CI:8.343-38.072)were risk factors for developing MDR-TB.Lineage 2(L2)strains accounted for 64.40%(136/191),whereas lineage 4(L4)accounted for 28.80%(55/191).The most common drug resistance mutations were katG Ser315Thr(62.50%,20/32)for INH,rpoB Ser450Leu(50.00%,12/24)for RIF,embB Met306Val(55.56%,5/9)for EMB,and rpsL Lys43Arg(80.95%,34/42)for SM.In conclusion,TB drug resistance was found to be a serious problem at a designated tu-berculosis hospital in Hunan in 2024.Strengthening the treatment and management of patients infected with L2 strains,those with co-morbid diabetes,and retreatment cases is crucial for preventing and controlling the emergence of drug-resistant TB.关键词
结核分枝杆菌/耐药/影响因素/突变/谱系Key words
Mycobacterium tuberculosis/drug resistance/associated factors/mutation/lineage分类
医药卫生引用本文复制引用
李吉祥,王珏,段洁,万康林,袁秀琴,刘海灿,郭婧玮,何心越,王瑞欢,赵秀芹,李马超,李桂莲,赵丽丽,王瑞白..2024年湖南某结核病定点医院结核病流行病学和耐药特征分析[J].中国人兽共患病学报,2025,41(10):1040-1047,8.基金项目
国家重点研发专项(No.2023YFC2307201) National Key Research and Development Program(No.2023YFC2307201) （No.2023YFC2307201）
