目的 分析淮北市痰培养阳性菌株的耐药状况,指导结核病的临床用药。 方法 收集近3年淮北市初复治患者痰培养阳性的菌株, 采用比例法药敏试验,对 302株痰培养阳性菌株进行菌种鉴定及药物敏感性试验,药敏试验的抗结核药物包括一线和二线临床用药,共13种抗结核药物。结果 共分离出结核分枝杆菌297株,非结核分枝杆菌5株,297株结核分枝杆菌的耐药性,全部敏感的菌株为217 株,占73.06%;耐药菌株 80株,耐药率26.94%,其中,多耐药菌株30 株,耐药率10.10%,耐多药菌株24株,耐药率8.08%,单耐药菌株25株,耐药率8.42%。初治患者耐药率22.39%,复治患者耐药率36.46%,差异有统计学意义(χ²=6.54,P＜0. 05)。结论 淮北市结核分枝杆菌耐药比例较高,在制定结核病防控策略时应给予充分重视。

Objective To analyze the drug resistance of sputum culture positive strains,and provide the clinical reference for tuberculosis prevention and control in Huaibei city. Methods A total of 302 positive strains of sputum culture were identified by drug sensitivity test which included first-line and second-line clinical drugs. 13 kinds of antituberculous drugs were identified. Results A total of 297 strains of mycobacterium tuberculosis and 5 non-tuberculous mycobacterium were isolated. There were 217 susceptible strains, accounting for 73.06%. There were 80 drug-resistant strains, and the resistance rate was 26.94%. There were 30 multidrug-resistant strains, and the resistance rate was 10.10%. There were 24 multi drug resistant strains, and the resistance rate was 8.08%. There were 8 single drug resistant strains, and the drug resistance rate was 8.42%. The drug resistance rate of newly treated patients was 22.39%, the drug resistance rate of re-treated patients was 36.46% and the difference was statistically significant. (χ²=6.54,P＜0. 05). Conclusion The proportion of drug resistant mycobacterium tuberculosis in Huaibei city was high, so we should pay more attention to the strategy of tuberculosis prevention and control.