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Article(id=1241035545879564599, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407522, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1722182400000, receivedDateStr=2024-07-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815531463, onlineDateStr=2026-03-18, pubDate=1735056000000, pubDateStr=2024-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815531463, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815531463, creator=13701087609, updateTime=1773815531463, updator=13701087609, issue=Issue{id=1241035543589483182, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='24', pageStart='4417', pageEnd='4608', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815530917, creator=13701087609, updateTime=1773815686426, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241036195896029478, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241036195896029479, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4512, endPage=4516, ext={EN=ArticleExt(id=1241035546185748796, articleId=1241035545879564599, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Distribution and drug resistance analysis of tuberculosis in various districts and counties of Changsha, 2021-2023, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the status of drug resistance of Mycobacterium tuberculosis(M.tuberculosis) isolated from drug resistance monitoring stations in Changsha from 2021 to 2023, and to provide reference for the control effect of drug-resistant tuberculosis.

Methods

The positive specimens from designated medical institutions in Changsha were collected and sent to our hospital together with the basic information of patients for further M.tuberculosis drug susceptibility test. Drug susceptibility tests were performed on all samples by proportional method, including 8 drugs, such as RFP, INH, EMB, SM, OFX, PAS, TH, KM, etc, and the qualitative data were analyzed by χ2 test.

Results

Among the 3 037 isolates, 2 534 were fully sensitive and 503 were drug-resistant, and the total drug resistance rate was 16.56%. Among them, 316 were single drug resistant, and the drug resistance rate was 10.41%. There were 81 multi-drug resistant strains (2.67%) and 106 poly-drug resistant strains (3.49%). The drug resistance sequences of any drug were INH, SM and RFP, 9.02%, 6.98% and 3.65%, respectively. The top three of multi-drug resistant patterns were INH+RFP (0.66%), INH+RFP+SM (0.4%) and INH+RFP+SM+EMB (0.36%), respectively. The top three poly-drug resistant patterns were INH+SM (1.15%), INH+TH1321 (0.4%) and INH+EMB (0.2%), respectively. In addition, from year of 2021 to 2023, the resistance of M.tuberculosis to RFP, EMB, and TH1321 drugs in Changsha area showed a decreasing trend year by year (P<0.05), but the overall resistance rate of patients in Changsha urban area was significantly higher than that in other districts and counties.

Conclusion

Compared with other provinces and cities, the overall drug resistance rate of tuberculosis patients in Changsha is low, but the drug resistance rate of tuberculosis in Changsha urban area is significantly higher than that in other districts and counties, which should arouse the attention of relevant departments.

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目的

分析2021—2023年长沙各区县耐药监测点分离的结核分枝杆菌耐药现状，为结核病的精准防控提供参考。

方法

收集2021—2023年长沙各区县定点医疗机构送检的阳性标本，连同患者基本信息一起送至本院实验室做结核药敏试验。采用比例法对所有标本进行药敏试验，药物包括RFP、INH、EMB、SM、OFX、PAS、TH、KM等8种药物，χ2检验对定性资料进行分析。

结果

本次分离的3 037例菌株中，全敏菌株2 534例，耐药菌株503例，总耐药率为16.56%，其中，单耐药菌株316例，耐药率为10.41%；耐多药菌株81例，耐药率为2.67%，多耐药率为106例，耐药率为3.49%；任一药物耐药顺位分别为INH、SM和RFP，分别为9.02%、6.98%和3.65%，耐多药中排行前三分别为INH+RFP（0.66%）、INH+RFP+SM（0.4%）和INH+RFP+SM+EMB（0.36%），多耐药排行前三分别为INH+SM（1.15%）、INH+TH1321（0.4%）和INH+EMB（0.2%）。此外，2021—2023年间长沙地区结核分枝杆菌对RFP、EMB和TH1321药物耐药性呈逐年下降趋势（P<0.05），但长沙城区患者总体耐药率显著高于其他区县。

结论

与其他省市相比，长沙地区结核病患者总体耐药率偏低，但长沙城区结核耐药率显著高于其他区县，应该引起相关部门的高度重视。

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马小华，E-mail:
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罗莉（1983—），女，本科，副主任技师，研究方向：临床微生物学检验

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罗莉（1983—），女，本科，副主任技师，研究方向：临床微生物学检验

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罗莉（1983—），女，本科，副主任技师，研究方向：临床微生物学检验

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tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, orderNo=4, keyword=监测)], refs=[Reference(id=1241069994608489252, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［1］, rfOrder=0, authorNames=World Health Organization, journalName=null, refType=null, unstructuredReference=World Health Organization. Global tuberculosis report 2023［EB/OL］. ［2024-11-17］. https://www.who.int/publications/i/item/9789240083851., articleTitle=Global tuberculosis report 2023, refAbstract=null), Reference(id=1241069994717541162, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2023, volume=8, issue=6, pageStart=73, pageEnd=78, url=null, language=null, rfNumber=［2］, rfOrder=1, authorNames=卢春容, 谭卫国, 陆普选, journalName=新发传染病电子杂志, refType=null, unstructuredReference=卢春容，谭卫国，陆普选，等．2023年WHO全球结核病报告：全球与中国关键数据分析［J］．新发传染病电子杂志, 2023, 8(6): 73-78., articleTitle=2023年WHO全球结核病报告：全球与中国关键数据分析, refAbstract=null), Reference(id=1241069994851758896, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2023, volume=8, issue=6, pageStart=73, pageEnd=78, url=null, language=null, rfNumber=［2］, rfOrder=2, authorNames=Lu CR, Tan WG, Lu PX, journalName=Electronic Journal of Emerging Infectious Diseases, refType=null, unstructuredReference=Lu CR, Tan WG, Lu PX, et al. 2023 WHO tuberculosis report:key data analysis for China and the global world［J］. Electronic Journal of Emerging Infectious Diseases, 2023, 8(6): 73-78. (In Chinese), articleTitle=2023 WHO tuberculosis report:key data analysis for China and the global world, refAbstract=null), Reference(id=1241069994969199412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2023, volume=2023, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［3］, rfOrder=3, authorNames=Mbewana Ntshanka NG, Msagati TAM, journalName=The Canadian Journal of Infectious Diseases & Medical Microbiology, refType=null, unstructuredReference=Mbewana Ntshanka NG, Msagati TAM. Trends and progress on antibiotic-resistant Mycobacterium tuberculosis and genes in relation to human immunodeficiency virus［J］. The Canadian Journal of Infectious Diseases & Medical Microbiology, 2023, 2023: 6659212., articleTitle=Trends and progress on antibiotic-resistant Mycobacterium tuberculosis and genes in relation to human immunodeficiency virus, refAbstract=null), Reference(id=1241069995069862714, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2017, volume=74, issue=Suppl 1, pageStart=S128, pageEnd=S135, url=null, language=null, rfNumber=［4］, rfOrder=4, authorNames=Outhred AC, Britton PN, Marais BJ, journalName=The Journal of Infection, refType=null, unstructuredReference=Outhred AC, Britton PN, Marais BJ. Drug-resistant tuberculosis-primary transmission and management［J］. The Journal of Infection, 2017, 74 Suppl 1: S128-S135., articleTitle=Drug-resistant tuberculosis-primary transmission and management, refAbstract=null), Reference(id=1241069995199886144, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2019, volume=10, issue=8, pageStart=1342, pageEnd=1360, url=null, language=null, rfNumber=［5］, rfOrder=5, authorNames=Mabhula A, Singh V, journalName=MedChemComm, refType=null, unstructuredReference=Mabhula A, Singh V. Drug-resistance in Mycobacterium tuberculosis: where we stand［J］. MedChemComm, 2019, 10(8): 1342-1360., articleTitle=Drug-resistance in Mycobacterium tuberculosis: where we stand, refAbstract=null), Reference(id=1241069995308938052, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2015, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［6］, rfOrder=6, authorNames=赵雁林, 逄宇, journalName=结核病实验室检验规程, refType=null, unstructuredReference=赵雁林，逄宇．结核病实验室检验规程［M］．北京：人民卫生出版社，2015．, articleTitle=null, refAbstract=null), Reference(id=1241069995409601353, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2015, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［6］, rfOrder=7, authorNames=Zhao YL, Pang Y, journalName=Tuberculosis laboratory test procedures, refType=null, unstructuredReference=Zhao YL, Pang Y. Tuberculosis laboratory test procedures［M］. Beijing: People’s Medical Publishing House, 2015. (In Chinese), articleTitle=null, refAbstract=null), Reference(id=1241069995518653263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=43, issue=12, pageStart=1226, pageEnd=1238, url=null, language=null, rfNumber=［7］, rfOrder=8, authorNames=刘一典, journalName=中国防痨杂志, refType=null, unstructuredReference=刘一典．复治肺结核病诊断和治疗专家共识［J］．中国防痨杂志, 2021, 43(12): 1226-1238., articleTitle=复治肺结核病诊断和治疗专家共识, refAbstract=null), Reference(id=1241069995615122260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=43, issue=12, pageStart=1226, pageEnd=1238, url=null, language=null, rfNumber=［7］, rfOrder=9, authorNames=Liu YD, journalName=Chinese Journal of Antituberculosis, refType=null, unstructuredReference=Liu YD. Expert consensus on the diagnosis and treatment of retreated tuberculosis［J］. Chinese Journal of Antituberculosis, 2021, 43(12): 1226-1238. (In Chinese), articleTitle=Expert consensus on the diagnosis and treatment of retreated tuberculosis, refAbstract=null), Reference(id=1241069995728368477, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2018, volume=36, issue=1, pageStart=38, pageEnd=46, url=null, language=null, rfNumber=［8］, rfOrder=10, authorNames=Cardona PJ, journalName=Enfermedades Infecciosas y Microbiologia Clinica, refType=null, unstructuredReference=Cardona PJ. Pathogenesis of tuberculosis and other mycobacteriosis［J］. Enfermedades Infecciosas y Microbiologia Clinica, 2018, 36(1): 38-46., articleTitle=Pathogenesis of tuberculosis and other mycobacteriosis, refAbstract=null), Reference(id=1241069995824837474, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=1, pageStart=185, pageEnd=null, url=null, language=null, rfNumber=［9］, rfOrder=11, authorNames=Liu L, Zhao XJ, Wu XY, journalName=BMC Microbiology, refType=null, unstructuredReference=Liu L, Zhao XJ, Wu XY, et al. Prevalence and molecular characteristics of drug-resistant Mycobacterium tuberculosis in Hainan, China: from 2014 to 2019［J］. BMC Microbiology, 2021, 21(1): 185., articleTitle=Prevalence and molecular characteristics of drug-resistant Mycobacterium tuberculosis in Hainan, China: from 2014 to 2019, refAbstract=null), Reference(id=1241069995950666601, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2020, volume=9, issue=2, pageStart=1028, pageEnd=1034, url=null, language=null, rfNumber=［10］, rfOrder=12, authorNames=Kumar V, Jorwal P, Soneja M, journalName=Journal of Family Medicine and Primary Care, refType=null, unstructuredReference=Kumar V, Jorwal P, Soneja M, et al. Evaluation of rapid diagnostic tests and assessment of risk factors in drug-resistant pulmonary tuberculosis［J］. Journal of Family Medicine and Primary Care, 2020, 9(2): 1028-1034., articleTitle=Evaluation of rapid diagnostic tests and assessment of risk factors in drug-resistant pulmonary tuberculosis, refAbstract=null), Reference(id=1241069996072301422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=48, issue=18, pageStart=3425, pageEnd=3429, url=null, language=null, rfNumber=［11］, rfOrder=13, authorNames=李德富, 俞玉琪, 卢曲琴, journalName=现代预防医学, refType=null, unstructuredReference=李德富，俞玉琪，卢曲琴，等．江西省耐药结核病治疗现状与抗结核药治疗费用分析［J］．现代预防医学, 2021, 48(18): 3425-3429., articleTitle=江西省耐药结核病治疗现状与抗结核药治疗费用分析, refAbstract=null), Reference(id=1241069996185547633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=48, issue=18, pageStart=3425, pageEnd=3429, url=null, language=null, rfNumber=［11］, rfOrder=14, authorNames=Li DF, Yu YQ, Lu QQ, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Li DF, Yu YQ, Lu QQ, et al. Analysis of treatment status of drug-resistant tuberculosis and cost of anti-tuberculosis drugs in Jiangxi Province［J］. Modern Preventive Medicine, 2021, 48(18): 3425-3429. (In Chinese), articleTitle=Analysis of treatment status of drug-resistant tuberculosis and cost of anti-tuberculosis drugs in Jiangxi Province, refAbstract=null), Reference(id=1241069996277822326, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=156, issue=8, pageStart=393, pageEnd=401, url=null, language=null, rfNumber=［12］, rfOrder=15, authorNames=Caminero Luna JA, Pérez Mendoza G, Rodríguez de Castro F, journalName=Medicina Clinica, refType=null, unstructuredReference=Caminero Luna JA, Pérez Mendoza G, Rodríguez de Castro F. Multi-drug resistant tuberculosis, ten years later［J］. Medicina Clinica, 2021, 156(8): 393-401., articleTitle=Multi-drug resistant tuberculosis, ten years later, refAbstract=null), Reference(id=1241069996449788801, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［13］, rfOrder=16, authorNames=Liebenberg D, Gordhan BG, Kana BD, journalName=Frontiers in Cellular and Infection Microbiology, refType=null, unstructuredReference=Liebenberg D, Gordhan BG, Kana BD. Drug resistanttuberculosis: Implications for transmission, diagnosis, and disease management［J］. Frontiers in Cellular and Infection Microbiology, 2022, 12: 943545., articleTitle=Drug resistanttuberculosis: Implications for transmission, diagnosis, and disease management, refAbstract=null), Reference(id=1241069996579812230, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=2, pageStart=127, pageEnd=140, url=null, language=null, rfNumber=［14］, rfOrder=17, authorNames=国家呼吸内科医疗质量控制中心, 中华医学会结核病学分会, 中国防痨协会结核病控制专业分会, journalName=中国防痨杂志, refType=null, unstructuredReference=国家呼吸内科医疗质量控制中心，中华医学会结核病学分会，中国防痨协会结核病控制专业分会，等．综合医疗机构肺结核早期发现临床实践指南［J］．中国防痨杂志, 2024, 46(2): 127-140., articleTitle=综合医疗机构肺结核早期发现临床实践指南, refAbstract=null), Reference(id=1241069998047818632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=2, pageStart=127, pageEnd=140, url=null, language=null, rfNumber=［14］, rfOrder=18, authorNames=National Center for Medical Quality Control of Respiratory Medicine, Tuberculosis Branch of Chinese Medical Association, Tuberculosis Control Branch of Chinese Tuberculosis Association, journalName=Chinese Journal of Antituberculosis, refType=null, unstructuredReference=National Center for Medical Quality Control of Respiratory Medicine, Tuberculosis Branch of Chinese Medical Association, Tuberculosis Control Branch of Chinese Tuberculosis Association, et al. Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities［J］. Chinese Journal of Antituberculosis, 2024, 46(2): 127-140. (In Chinese), articleTitle=Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities, refAbstract=null), Reference(id=1241069998131704717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=5, pageStart=531, pageEnd=537, url=null, language=null, rfNumber=［15］, rfOrder=19, authorNames=包训迪, 梁锁, 李军, journalName=中国防痨杂志, refType=null, unstructuredReference=包训迪，梁锁，李军，等．2016—2022年安徽省结核病耐药监测结果分析［J］．中国防痨杂志, 2024, 46(5): 531-537., articleTitle=2016—2022年安徽省结核病耐药监测结果分析, refAbstract=null), Reference(id=1241069998274311059, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=5, pageStart=531, pageEnd=537, url=null, language=null, rfNumber=［15］, rfOrder=20, authorNames=Bao XD, Liang S, Li J, journalName=Chinese Journal of Antituberculosis, refType=null, unstructuredReference=Bao XD, Liang S, Li J, et al. Analysis ofmycobacterium tuberculosis drug resistance monitoring in Anhui province from 2016 to 2022［J］. Chinese Journal of Antituberculosis, 2024, 46(5): 531-537. (In Chinese), articleTitle=Analysis ofmycobacterium tuberculosis drug resistance monitoring in Anhui province from 2016 to 2022, refAbstract=null), Reference(id=1241069998412723098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=43, issue=4, pageStart=364, pageEnd=369, url=null, language=null, rfNumber=［16］, rfOrder=21, authorNames=白桦, 郭婧玮, 胡培磊, journalName=中国防痨杂志, refType=null, unstructuredReference=白桦，郭婧玮，胡培磊，等．2014—2018年湖南省耐药监测点结核分枝杆菌耐药监测结果分析［J］．中国防痨杂志, 2021, 43(4): 364-369., articleTitle=2014—2018年湖南省耐药监测点结核分枝杆菌耐药监测结果分析, refAbstract=null), Reference(id=1241069998513386398, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2021, volume=43, issue=4, pageStart=364, pageEnd=369, url=null, language=null, rfNumber=［16］, rfOrder=22, authorNames=Bai H, Guo JW, Hu PL, journalName=Chinese Journal of Antituberculosis, refType=null, unstructuredReference=Bai H, Guo JW, Hu PL, et al. Analysis ofdrug resistance surveillance results of Mycobacterium tuberculosis in Hu’nan Province from 2014 to 2018［J］. Chinese Journal of Antituberculosis, 2021, 43(4): 364-369. (In Chinese), articleTitle=Analysis ofdrug resistance surveillance results of Mycobacterium tuberculosis in Hu’nan Province from 2014 to 2018, refAbstract=null), Reference(id=1241069998618244005, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=59, issue=3, pageStart=515, pageEnd=520, url=null, language=null, rfNumber=［17］, rfOrder=23, authorNames=郝金奇, 张兰, 余艳琴, journalName=安徽医科大学学报, refType=null, unstructuredReference=郝金奇，张兰，余艳琴，等．内蒙古地区结核病的耐药现状及影响因素研究［J］．安徽医科大学学报, 2024, 59(3): 515-520., articleTitle=内蒙古地区结核病的耐药现状及影响因素研究, refAbstract=null), Reference(id=1241069998723101611, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=59, issue=3, pageStart=515, pageEnd=520, url=null, language=null, rfNumber=［17］, rfOrder=24, authorNames=Hao JQ, Zhang L, Yu YQ, journalName=Acta Universitatis Medicinalis Anhui, refType=null, unstructuredReference=Hao JQ, Zhang L, Yu YQ, et al. Status quo and influencing factors of drug resistance of tuberculosis in Inner Mongolia［J］. Acta Universitatis Medicinalis Anhui, 2024, 59(3): 515-520. (In Chinese), articleTitle=Status quo and influencing factors of drug resistance of tuberculosis in Inner Mongolia, refAbstract=null), Reference(id=1241069998853125040, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=3, pageStart=340, pageEnd=348, url=null, language=null, rfNumber=［18］, rfOrder=25, authorNames=李江红, 雷彩英, 颜淑萍, journalName=中国防痨杂志, refType=null, unstructuredReference=李江红，雷彩英，颜淑萍，等．2015—2022年天水市肺结核患者耐药情况及利福平耐药特征分析［J］．中国防痨杂志, 2024, 46(3): 340-348., articleTitle=2015—2022年天水市肺结核患者耐药情况及利福平耐药特征分析, refAbstract=null), Reference(id=1241069998995731381, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=3, pageStart=340, pageEnd=348, url=null, language=null, rfNumber=［18］, rfOrder=26, authorNames=Li JH, Lei CY, Yan SP, journalName=Chinese Journal of Antituberculosis, refType=null, unstructuredReference=Li JH, Lei CY, Yan SP, et al. Analysis of drug resistance situation results and rifampicin resistance characteristics in pulmonary tuberculosis patients in Tianshui City from 2015 to 2022［J］. Chinese Journal of Antituberculosis, 2024, 46(3): 340-348. (In Chinese), articleTitle=Analysis of drug resistance situation results and rifampicin resistance characteristics in pulmonary tuberculosis patients in Tianshui City from 2015 to 2022, refAbstract=null), Reference(id=1241069999113171898, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2016, volume=21, issue=10, pageStart=1751, pageEnd=1753, 1756, url=null, language=null, rfNumber=［19］, rfOrder=27, authorNames=潘建华, 罗丹, 石国民, journalName=临床肺科杂志, refType=null, unstructuredReference=潘建华，罗丹，石国民，等．湖南长沙市结核分枝杆菌耐药情况分析［J］．临床肺科杂志, 2016, 21(10): 1751-1753, 1756., articleTitle=湖南长沙市结核分枝杆菌耐药情况分析, refAbstract=null), Reference(id=1241069999230612414, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2016, volume=21, issue=10, pageStart=1751, pageEnd=1753, 1756, url=null, language=null, rfNumber=［19］, rfOrder=28, authorNames=Pan JH, Luo D, Shi GM, journalName=Journal of Clinical Pulmonary Medicine, refType=null, unstructuredReference=Pan JH, Luo D, Shi GM, et al. Drug resistance analysis onMycobacterium tuberculosis in patients with pulmonary tuberculosis in Changsha area［J］. Journal of Clinical Pulmonary Medicine, 2016, 21(10): 1751-1753, 1756. (In Chinese), articleTitle=Drug resistance analysis onMycobacterium tuberculosis in patients with pulmonary tuberculosis in Changsha area, refAbstract=null), Reference(id=1241069999348052931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=9, pageStart=1173, pageEnd=1178, url=null, language=null, rfNumber=［20］, rfOrder=29, authorNames=杨国庆, 何杨, 杨曦霞, journalName=预防医学情报杂志, refType=null, unstructuredReference=杨国庆，何杨，杨曦霞，等．2014—2022年德阳市结核分枝杆菌耐药情况分析［J］．预防医学情报杂志, 2024, 40(9): 1173-1178., articleTitle=2014—2022年德阳市结核分枝杆菌耐药情况分析, refAbstract=null), Reference(id=1241069999473882052, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=9, pageStart=1173, pageEnd=1178, url=null, language=null, rfNumber=［20］, rfOrder=30, authorNames=Yang GQ, He Y, Yang XX, journalName=Journal of Preventive Medicine Information, refType=null, unstructuredReference=Yang GQ, He Y, Yang XX, et al. Analysis on drug resistance of mycobacterium tuberculosis in Deyang City from 2014 to 2022［J］. Journal of Preventive Medicine Information, 2024, 40(9): 1173-1178. (In Chinese), articleTitle=Analysis on drug resistance of mycobacterium tuberculosis in Deyang City from 2014 to 2022, refAbstract=null), Reference(id=1241069999591322575, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=1, pageStart=102, pageEnd=106, url=null, language=null, rfNumber=［21］, rfOrder=31, authorNames=黄静静, 柯芊羽, 侯萍, journalName=中国热带医学, refType=null, unstructuredReference=黄静静，柯芊羽，侯萍，等．海南省2018—2022年结核分枝杆菌耐药监测分析［J］．中国热带医学, 2024, 24(1): 102-106., articleTitle=海南省2018—2022年结核分枝杆菌耐药监测分析, refAbstract=null), Reference(id=1241069999679402960, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=1, pageStart=102, pageEnd=106, url=null, language=null, rfNumber=［21］, rfOrder=32, authorNames=Huang JJ, Ke QY, Hou P, journalName=China Tropical Medicine, refType=null, unstructuredReference=Huang JJ, Ke QY, Hou P, et al. Surveillance of drug resistance to Mycobacterium tuberculosis in Hainan Province,2018-2022［J］. China Tropical Medicine, 2024, 24(1): 102-106. (In Chinese), articleTitle=Surveillance of drug resistance to Mycobacterium tuberculosis in Hainan Province,2018-2022, refAbstract=null)], funds=[Fund(id=1241069994218418954, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, awardId=2021JJ70130, language=CN, fundingSource=湖南省自然科学基金项目(2021JJ70130), fundOrder=null, country=null), Fund(id=1241069994340053777, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, awardId=D202303086260, language=CN, fundingSource=湖南省卫健委科研项目(D202303086260), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241069986496704886, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, xref=null, ext=[AuthorCompanyExt(id=1241069986509287800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, companyId=1241069986496704886, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Laboratory medicine, Changsha Central Hospital, Changsha, Huhan 410004, China), AuthorCompanyExt(id=1241069986517676410, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, companyId=1241069986496704886, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=长沙市中心医院检验科（南华大学附属长沙中心医院），湖南 长沙 41004)])], figs=[ArticleFig(id=1241069991336932010, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=EN, label=Fig.1, caption=Comparison of drug resistance rates in different years, figureFileSmall=4BV/g5GfQ9WSISPqXttb0w==, figureFileBig=AIHRdwTURhcV0l4RaBVb+g==, tableContent=null), ArticleFig(id=1241069991555035836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, label=图1, caption=不同年份药物耐药率比较, figureFileSmall=4BV/g5GfQ9WSISPqXttb0w==, figureFileBig=AIHRdwTURhcV0l4RaBVb+g==, tableContent=null), ArticleFig(id=1241069991735390917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=EN, label=Table 1, caption=

Comparison of drug resistance in different groups of tuberculosis patients

, figureFileSmall=null, figureFileBig=null, tableContent=
组别总株数耐药株数耐药率
（%）		χ2P
性别1.3240.250
男230137116.12
女73613217.93
年龄(岁)3.6660.300
12~821417.07
21~4318419.49
41~103817316.67
61~96148623215.61
年份2.2510.324
2021107617816.54
202276613918.15
2023119518615.56
), ArticleFig(id=1241069991873802955, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, label=表1, caption=

结核病患者不同组别菌株耐药率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别总株数耐药株数耐药率
（%）		χ2P
性别1.3240.250
男230137116.12
女73613217.93
年龄(岁)3.6660.300
12~821417.07
21~4318419.49
41~103817316.67
61~96148623215.61
年份2.2510.324
2021107617816.54
202276613918.15
2023119518615.56
), ArticleFig(id=1241069991970271950, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=EN, label=Table 2, caption=

Analysis of drug resistance in 3 037 patients

, figureFileSmall=null, figureFileBig=null, tableContent=
耐药谱耐药株数耐药率［%(95% CI)］构成比［%（n/503）］
任一耐药---
INH2749.02(8.00~10.04)-
RFP1113.65(2.99~4.32)-
EMB802.63(2.06~3.20)-
SM2126.98(6.07~7.89)-
OFX902.96(2.36~3.57)-
PAS290.95(0.61~1.30)-
TH1321401.32(0.91~1.72)-
KM230.76(0.45~1.07)-
单耐药31610.41(9.32~11.49)62.82
INH1033.39(2.75~4.04)20.48
RFP240.79(0.48~1.11)4.77
EMB200.66(0.37~0.95)3.98
SM963.16(2.54~3.78)19.09
OFX541.78(1.31~2.25)10.74
PAS80.26(0.08~0.45)1.59
TH132150.16(0.02~0.31)0.99
KM60.20(0.04~0.36)1.19
耐多药812.67(2.09~3.24)16.10
INH+RFP200.66(0.37~0.95)3.98
INH+RFP+SM120.40(0.17~0.62)2.39
INH+RFP+EMB80.26(0.08~0.45)1.59
INH+RFP+TH40.13(0.00~0.26)0.80
INH+RFP+SM+EMB110.36(0.15~0.58)2.19
INH+RFP+SM+OFX40.13(0.00~0.26)0.80
INH+RFP+SM+EMB+OFX100.33(0.13~0.53)1.99
多耐药1063.49(2.84~4.14)21.07
INH+SM351.15(0.77~1.53)6.96
INH+EMB60.20(0.04~0.36)1.19
INH+OFX50.16(0.02~0.31)0.99
INH+TH1321120.40(0.17~0.62)2.39
RFP+SM50.16(0.02~0.31)0.99
SM+KM40.13(0.00~0.26)0.80
EMB+OFX30.10(-0.01~0.21)0.60
INH+SM+EMB40.13(0.00~0.26)0.80
INH+SM+OFX30.10(-0.01~0.21)0.60
INH+SM+PAS50.16(0.02~0.31)0.99
INH+SM+KM30.10(-0.01~0.21)0.60
其他耐药组合数在2株及以下，共33株，耐药谱见备注
合计50316.56(15.2~17.88)100.00
), ArticleFig(id=1241069992075129558, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, label=表2, caption=

3 037株细菌耐药性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
耐药谱耐药株数耐药率［%(95% CI)］构成比［%（n/503）］
任一耐药---
INH2749.02(8.00~10.04)-
RFP1113.65(2.99~4.32)-
EMB802.63(2.06~3.20)-
SM2126.98(6.07~7.89)-
OFX902.96(2.36~3.57)-
PAS290.95(0.61~1.30)-
TH1321401.32(0.91~1.72)-
KM230.76(0.45~1.07)-
单耐药31610.41(9.32~11.49)62.82
INH1033.39(2.75~4.04)20.48
RFP240.79(0.48~1.11)4.77
EMB200.66(0.37~0.95)3.98
SM963.16(2.54~3.78)19.09
OFX541.78(1.31~2.25)10.74
PAS80.26(0.08~0.45)1.59
TH132150.16(0.02~0.31)0.99
KM60.20(0.04~0.36)1.19
耐多药812.67(2.09~3.24)16.10
INH+RFP200.66(0.37~0.95)3.98
INH+RFP+SM120.40(0.17~0.62)2.39
INH+RFP+EMB80.26(0.08~0.45)1.59
INH+RFP+TH40.13(0.00~0.26)0.80
INH+RFP+SM+EMB110.36(0.15~0.58)2.19
INH+RFP+SM+OFX40.13(0.00~0.26)0.80
INH+RFP+SM+EMB+OFX100.33(0.13~0.53)1.99
多耐药1063.49(2.84~4.14)21.07
INH+SM351.15(0.77~1.53)6.96
INH+EMB60.20(0.04~0.36)1.19
INH+OFX50.16(0.02~0.31)0.99
INH+TH1321120.40(0.17~0.62)2.39
RFP+SM50.16(0.02~0.31)0.99
SM+KM40.13(0.00~0.26)0.80
EMB+OFX30.10(-0.01~0.21)0.60
INH+SM+EMB40.13(0.00~0.26)0.80
INH+SM+OFX30.10(-0.01~0.21)0.60
INH+SM+PAS50.16(0.02~0.31)0.99
INH+SM+KM30.10(-0.01~0.21)0.60
其他耐药组合数在2株及以下，共33株，耐药谱见备注
合计50316.56(15.2~17.88)100.00
), ArticleFig(id=1241069993614439137, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=EN, label=Table 3, caption=

Distribution of TB cases in different districts and counties in Changsha

, figureFileSmall=null, figureFileBig=null, tableContent=
区县株数耐药数耐药率(%)
长沙城区55912221.82
岳麓区27933.33
雨花区701420.00
望城区611626.23
天心区571526.32
开福区2555220.39
芙蓉区891617.98
宁乡90714315.77a
浏阳116117014.64ab
长沙县4106816.59abc
), ArticleFig(id=1241069993740268266, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, label=表3, caption=

长沙地区结核病例不同区县分布

, figureFileSmall=null, figureFileBig=null, tableContent=
区县株数耐药数耐药率(%)
长沙城区55912221.82
岳麓区27933.33
雨花区701420.00
望城区611626.23
天心区571526.32
开福区2555220.39
芙蓉区891617.98
宁乡90714315.77a
浏阳116117014.64ab
长沙县4106816.59abc
), ArticleFig(id=1241069993887068920, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=EN, label=Table 4, caption=

Analysis of Drug Resistance of Mycobacterium tuberculosis from 2021 to 2013

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总数药物耐药（株,%）
INHSMRFPEMBOFXPASTH1321KM
20211 07795(8.82)80(7.43)37(3.44)40(3.71)33(3.06)9(0.84)21(1.95)6(0.56)
202276677(10.05)56(7.31)45(5.87)a21(2.74)a20(2.61)5(0.65)11(1.44)a10(1.31)
20231 195102(8.54)76(6.36)25(2.09)ab19(1.59)ab37(3.09)15(1.26)8(0.67)ab7(0.59)
χ2值1.3881.17019.69210.0150.4422.0427.2604.106
P0.4990.557<0.0010.0070.8020.360.0270.128
), ArticleFig(id=1241069994008703742, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035545879564599, language=CN, label=表4, caption=

2021—2013年结核分枝杆菌耐药情况分析

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总数药物耐药（株,%）
INHSMRFPEMBOFXPASTH1321KM
20211 07795(8.82)80(7.43)37(3.44)40(3.71)33(3.06)9(0.84)21(1.95)6(0.56)
202276677(10.05)56(7.31)45(5.87)a21(2.74)a20(2.61)5(0.65)11(1.44)a10(1.31)
20231 195102(8.54)76(6.36)25(2.09)ab19(1.59)ab37(3.09)15(1.26)8(0.67)ab7(0.59)
χ2值1.3881.17019.69210.0150.4422.0427.2604.106
P0.4990.557<0.0010.0070.8020.360.0270.128
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2021—2023年长沙市各区县结核病患者分布及耐药性分析
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罗莉 , 石国民 , 潘建华 , 谭爱春 , 马小华
现代预防医学 | 基层卫生服务 2024,51(24): 4512-4516
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现代预防医学 | 基层卫生服务 2024, 51(24): 4512-4516
2021—2023年长沙市各区县结核病患者分布及耐药性分析
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罗莉, 石国民, 潘建华, 谭爱春, 马小华
作者信息
  • 长沙市中心医院检验科（南华大学附属长沙中心医院），湖南 长沙 41004

    • 罗莉（1983—），女，本科，副主任技师，研究方向：临床微生物学检验

通讯作者:

马小华，E-mail:
Distribution and drug resistance analysis of tuberculosis in various districts and counties of Changsha, 2021-2023
Li LUO, Guo-min SHI, Jian-hua PAN, Ai-chun TAN, Xiao-hua MA
Affiliations
  • Department of Laboratory medicine, Changsha Central Hospital, Changsha, Huhan 410004, China
出版时间: 2024-12-25 doi: 10.20043/j.cnki.MPM.202407522
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摘要
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目的

分析2021—2023年长沙各区县耐药监测点分离的结核分枝杆菌耐药现状，为结核病的精准防控提供参考。

方法

收集2021—2023年长沙各区县定点医疗机构送检的阳性标本，连同患者基本信息一起送至本院实验室做结核药敏试验。采用比例法对所有标本进行药敏试验，药物包括RFP、INH、EMB、SM、OFX、PAS、TH、KM等8种药物，χ2检验对定性资料进行分析。

结果

本次分离的3 037例菌株中，全敏菌株2 534例，耐药菌株503例，总耐药率为16.56%，其中，单耐药菌株316例，耐药率为10.41%；耐多药菌株81例，耐药率为2.67%，多耐药率为106例，耐药率为3.49%；任一药物耐药顺位分别为INH、SM和RFP，分别为9.02%、6.98%和3.65%，耐多药中排行前三分别为INH+RFP（0.66%）、INH+RFP+SM（0.4%）和INH+RFP+SM+EMB（0.36%），多耐药排行前三分别为INH+SM（1.15%）、INH+TH1321（0.4%）和INH+EMB（0.2%）。此外，2021—2023年间长沙地区结核分枝杆菌对RFP、EMB和TH1321药物耐药性呈逐年下降趋势（P<0.05），但长沙城区患者总体耐药率显著高于其他区县。

结论

与其他省市相比，长沙地区结核病患者总体耐药率偏低，但长沙城区结核耐药率显著高于其他区县，应该引起相关部门的高度重视。

长沙地区  /  结核病  /  耐药  /  监测
Objective

To investigate the status of drug resistance of Mycobacterium tuberculosis(M.tuberculosis) isolated from drug resistance monitoring stations in Changsha from 2021 to 2023, and to provide reference for the control effect of drug-resistant tuberculosis.

Methods

The positive specimens from designated medical institutions in Changsha were collected and sent to our hospital together with the basic information of patients for further M.tuberculosis drug susceptibility test. Drug susceptibility tests were performed on all samples by proportional method, including 8 drugs, such as RFP, INH, EMB, SM, OFX, PAS, TH, KM, etc, and the qualitative data were analyzed by χ2 test.

Results

Among the 3 037 isolates, 2 534 were fully sensitive and 503 were drug-resistant, and the total drug resistance rate was 16.56%. Among them, 316 were single drug resistant, and the drug resistance rate was 10.41%. There were 81 multi-drug resistant strains (2.67%) and 106 poly-drug resistant strains (3.49%). The drug resistance sequences of any drug were INH, SM and RFP, 9.02%, 6.98% and 3.65%, respectively. The top three of multi-drug resistant patterns were INH+RFP (0.66%), INH+RFP+SM (0.4%) and INH+RFP+SM+EMB (0.36%), respectively. The top three poly-drug resistant patterns were INH+SM (1.15%), INH+TH1321 (0.4%) and INH+EMB (0.2%), respectively. In addition, from year of 2021 to 2023, the resistance of M.tuberculosis to RFP, EMB, and TH1321 drugs in Changsha area showed a decreasing trend year by year (P<0.05), but the overall resistance rate of patients in Changsha urban area was significantly higher than that in other districts and counties.

Conclusion

Compared with other provinces and cities, the overall drug resistance rate of tuberculosis patients in Changsha is low, but the drug resistance rate of tuberculosis in Changsha urban area is significantly higher than that in other districts and counties, which should arouse the attention of relevant departments.

Changsha area  /  Tuberculosis  /  Drug resistance  /  Surveillance
罗莉, 石国民, 潘建华, 谭爱春, 马小华. 2021—2023年长沙市各区县结核病患者分布及耐药性分析. 现代预防医学, 2024 , 51 (24) : 4512 -4516 . DOI: 10.20043/j.cnki.MPM.202407522
Li LUO, Guo-min SHI, Jian-hua PAN, Ai-chun TAN, Xiao-hua MA. Distribution and drug resistance analysis of tuberculosis in various districts and counties of Changsha, 2021-2023[J]. Modern Preventive Medicine, 2024 , 51 (24) : 4512 -4516 . DOI: 10.20043/j.cnki.MPM.202407522
正文
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结核病是由结核分枝杆菌感染引起的，危害人类健康的重要的传染性疾病之一，也是全球公共卫生问题之一。2010—2020年期间，结核病发病率年递降率约为2%，尚未实现世界卫生组织“终止结核病流行”策略第一阶段目标。据2023年全球结核病报告数据显示，2022年全球估计有1 060万人新患结核病，结核病发病率在2020—2022年三年间增加了3.9%[1]。结核病发病率呈现抬头趋势，与世界卫生组织“终止结核病流行”策略确定2025年第二阶段性目标存在巨大差距。2022年中国结核病新发患者为74.8万，约占全球总数的7.1%，耐药结核病患者为3万例，耐药患者治疗覆盖率仅为82.8%[2]。由于结核病治疗过程中耐药结核分枝杆菌的出现，不仅给临床的治疗提供了极大的挑战[3]，也加剧了结核病的传播风险[4-5]。因此，继续加大对耐药结核病患者的筛查成为每个省市重点任务。近几年，我院作为长沙地区耐药结核监测定点医疗机构，主要收集来自长沙各个地区结核培养阳性的菌株进行进一步结核药物敏感试验，为长沙各个地区流行病学调查和耐药结核病防治参考提供依据。
1 对象与方法
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1.1 研究对象
1.1.1 菌株来源
收集2021年1月至2023年12月来自长沙各地区定点医疗机构经痰涂片抗酸染色阳性、影像学特征和临床症状疑似肺结核的患者进行痰分枝杆菌培养，将分枝杆菌培养阳性培养物送检至我院进行药物敏感试验，排除培养过程中污染、同年度重复的患者，最终入选3 037份标本。本研究收集信息时免除患者隐私信息，免知情同意，并经长沙市中心医院伦理委员会批准（批准号：2024医审第203号）。
1.1.2 药物来源
8种抗结核药物菌购于珠海贝索公司，相关药物及其浓培养基内终浓度为：异烟肼（Isoniazide，INH）0.2 μg/ml、链霉素（streptomycin, SM）4 μg/ml、利福平（rifampicin, RFP）40 μg/ml、乙胺丁醇（ethambutol, EMB）2 μg/ml、氧氟沙星（Ofloxacin, OFX）2 μg/ml、对氨基水杨酸钠（sodium para-aminosalicylate, PAS）1 μg/ml、丙硫异烟胺（Protionamide,TH1321）40 μg/ml和卡那霉素（Kanamycin, KM）30 μg/ml。
1.2 方法
1.2.1 结核分枝杆菌培养
结核分枝杆菌培养严格按照《结核病实验室检验规程》进行，简要操作如下：无菌痰杯中加入1~2倍体积的4% NaOH，震荡混匀，放置15 min，取150 μL加入酸性罗氏培养基中培养4~8周，可见呈颗粒、菜花状米黄色不透明菌落，将菌落涂片进行抗酸染色，显微镜下可见红色细长略带弯曲、可呈条索状杆菌即为抗酸杆菌，收集培养阳性培养物送检。
1.2.2 结核分枝杆菌比例法药敏试验
结核分枝杆菌药敏严格按照《结核病实验室检验规程》进行[6]，简要操作如下：向磨菌瓶加入无菌2~3滴生理盐水，刮取新鲜菌落放入磨菌瓶中，剧烈振荡1~2 min，静止15 min左右，取上层菌液转移到新的试管中，调整至麦氏浓度与麦氏1号标准比浊管一致，即为1 mg/ml菌悬液。将菌悬液按照要求稀释10-2 mg/ml和10-4 mg/ml，分别取0.01 ml稀释菌悬液均匀接种至含药培养基表面，拧紧盖子，放入36℃恒温培养箱培养4周观察结果。耐药百分比计算和结果解析：耐药百分比=含药培养基生长菌落数/对照培养基生长的菌落数×100%，若耐药百分比≥1%，认为受试菌对该抗结核药物耐药。
1.2.3 质量控制
为保证检测结果准确性，每批药敏试验均进行质控。室内质控包括培养基颜色、质地、凝固水、匀质性和无菌性均合格，每批药敏试验均以敏感的标准株H37RV进行控制，含药培养基培养均无分枝杆菌生长，无药对照组有分枝杆菌生长，表明该批次药物在控。此外，本实验室每年参加国家结核病参比实验室药敏熟练度测试结果均为优秀。
1.2.4 相关耐药定义[7]
耐药性分离：1）单耐药：结核分枝杆菌对一种抗结核药物耐药；2）任一耐药：结核菌分枝杆菌对任一种药物耐药（也可能对其他药物耐药）；3）耐多药：至少同时对利福平和异烟肼两种抗结核药物耐药；4）多耐药：对两种或两种以上抗结核药物耐药，但利福平和异烟肼不能同时耐药。
1.3 统计学分析
所有药敏试验结果均录入EXCEL 2007中并进行整理，采用SPSS 18软件进行统计学分析，计数资料采用n（%）表示，计量资料采用均数，两组间比较采用χ2检验，多重检验采用χ2分割检验，比较2021—2023年份间结核病耐药率差异。检验水准为α=0.05。
2 结果
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2.1 结核病患者一般特征分析
2021—2023年共收集来自长沙五区县结核培养为阳性的患者3 226例，经过去除同一人多次培养标本、去污染后，最终获得3 037株结核分枝杆菌样本，其中男性2 301人，女性736人，男女比例3.13∶1，最大年龄96岁，最小年龄12岁，平均年龄58.38岁，2021—2023年各区县送检样本数分别为1 076例、766例和1 195例。
2.2 结核病患者不同群体特征菌株耐药率比较
为了比较结核病患者性别、年龄段和不同年份菌株耐药情况，表1所示，经χ2检验，2021—2023年统计的各区县菌株在不同性别、不同年龄段和不同年份上均无统计学意义。说明2021—2023年结核菌耐药群体总体没有明显变化。
2.3 结核病患者结核菌耐药谱分析
3 037例患者菌株中，全敏2 534株，耐药503株，总的耐药率16.56%，其中，单耐药菌株316例，耐药率为10.41%，构成比62.82%；耐多药菌株81例，耐药率为2.67%，构成比16.10%；多耐药菌株106例，耐药率为3.49%，构成比21.07%。随后的分析中，细菌对任一药物耐药的药物排行前三分别为INH、SM、RFP，分别为9.02%、6.98%和3.65%。单耐药中排行前三分别为INH(3.39%)、SM(3.16%)和OFX(1.78%)。耐多药模式中排行前三为INH+RFP（0.66%）、INH+RFP+SM（0.4%）和INH+RFP+SM+EMB（0.36%）。多耐药模式中排行前三为INH+SM（1.15%）、INH+TH（0.4%）和INH+EMB（0.2%）。见表2所示。
2.4 结核病患者菌株区县分布
长沙地区2021—2023年各区县结核培养阳性患者菌株数量及耐药率具有显著性差异（χ2=14.714，P=0.002）,长沙城区耐药率为21.82%，其次为长沙县（16.59%）、宁乡（15.77%）和浏阳（14.64%）。经分割χ2检验分析，宁乡和浏阳与长沙城区具有统计学意义（分别为分割χ2=8.570，P=0.003; 分割χ2=13.810，P<0.001），说明长沙城区结核耐药率显著高于宁乡和浏阳的耐药率，见表3。
2.5 2021—2023年结核分枝杆菌耐药性分析
2021—2013年菌株耐药分析见表4，结核分枝杆菌对EMB、TH1321、RFP三种药物耐药率具有统计学差异(P<0.05)，经过χ2趋势检验，EMB、TH1321耐药率分别呈下降趋势（χ2趋势=9.993，P=0.002；χ2趋势=7.187，P=0.007）。RFP在2022年耐药率有上升的趋势，之后2023年显著下降，经过χ2趋势检验，无统计学差异（χ2趋势=3.387，P=0.066）。此外，INH、SM、OFX、PAS、KM等抗结核药物耐药率在三年期间变化不显著（P>0.05），见图1。
3 讨论
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结核分枝杆菌是引起结核病的病原体[8]，是结核病传播的“罪魁祸手”[9-10]，耐药结核菌株的出现则增加了患者经济负担[11]，也给临床医师带来极大的挑战[12-13]。因此，结核病的早期发现及耐药筛查是阻止结核病传播的关键环节[14]。本次结核耐药筛查的研究范围仅限于长沙城区和各区县，收集三年的耐药筛查数据进行分析，结果显示总的耐药率为16.56%，低于包训迪等报道的安徽省耐药结核检测结果（总耐药率为18.96%）[15]。此外，单耐药菌株耐药率为10.40%，耐多药为2.67%，多耐药为3.49%，本次筛查结果低于白桦等人的报道[16]。出现这种差异可能原因：1、研究人群不同，本次研究仅限于长沙城区和各区县监测点数据，而白桦等人研究的对象是湖南省5个监测点反馈的数据；2、筛查年份不同，本次筛查时段为2021—2023年，而白桦等人监测时段为2014—2018年，可能反映了长沙市耐药防控措施取得了成效的原因。
耐药谱方面，任一耐药药物中耐药率排行前三分别为INH、SM、RFP，分别为9.02%、6.98%和3.65%，显著低于内蒙古地区数据[17]。单耐药中排行前三分别为INH(3.39%)、SM(3.16%)和OFX(1.78%)，与内蒙古地区耐药顺差SM（7.27%）、INH（4.69%）和RFP（3.03%）有区别，可能与每个地区的用药习惯不同有关。此外，INH耐药性在本研究中排行靠前，可能是INH应用于结核病预防性或诊断性用药的结果。耐多药排行前三分别为INH+RFP（0.66%）、INH+RFP+SM（0.4%）、INH+RFP+SM+EMB（0.36%）和多耐药排行前三分别为INH+SM（1.15%）、INH+TH1321（0.4%）和INH+EMB（0.2%）均与内蒙古地区结核菌耐药顺位相似，与安徽省结核菌耐药顺位稍有差异。说明不同省份对于结核病的治疗方案可能存在一定的差异。
接着，本研究比较了患者性别、年龄以及不同年份之间均无显著性差异，与李江红等人报道的甘肃省天水市情况相似[18]。结核病耐药率在长沙各区县分布方面，长沙城区患者耐药率（21.82%）显著高于宁乡、浏阳地区，与文献[19-21]报道的总耐药率接近，可能与长沙城区流动人口相对密集易于传播有关。此外，本次分析的长沙市6个城区送检的样本相对浏阳、宁乡和长沙县偏少，可能原因是长沙城区内有三家结核病定点医疗机构，患者分散到各个定点医疗机构所致。值得指出的是，2021—2023年间细菌耐EMB、TH1321药物呈逐年下降趋势（P<0.05），可能是长沙地区耐药结核病防控取得成效，但仍然需要继续监测各区县未来几年的防控数据证实。此外，2022年，细菌对RFP耐药率小幅增加，但结核菌株数仅仅766株，可能与2022年新冠疫情严管情况下，病情较重的结核病患者是就医主体有关。
本研究也存在一定的局限性。由于本项目涉及多个区县和患者隐私，根据现有方案，各区县只需送检阳性培养菌株，没有将培养阴性患者信息送至我院，难以统计各个区县阳性率，这是本项目未来需要进一步改进的工作。
综上所述，本次研究对长沙地区各个区县阳性样本进行药敏分析，结果发现本次研究中总耐药率、单耐药率、耐多耐药率以及多耐药率等均低于白桦等人早期报道的耐药率，说明长沙地区总的结核耐药率低于全省平均水平，可能与长沙地区认真落实2019—2022年遏制结核病行动规划取得成效有关。但需要值得关注的是，长沙城区的耐药率高于其他区县，应该引起相关部门的高度重视。
基金
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  • 湖南省自然科学基金项目(2021JJ70130)
  • 湖南省卫健委科研项目(D202303086260)
文献
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参考文献 引证文献
排序方式：
［1］
World Health Organization. Global tuberculosis report 2023［EB/OL］. ［2024-11-17］. https://www.who.int/publications/i/item/9789240083851.
［2］
卢春容，谭卫国，陆普选，等．2023年WHO全球结核病报告：全球与中国关键数据分析［J］．新发传染病电子杂志, 2023, 8(6): 73-78.
Lu CR, Tan WG, Lu PX, et al. 2023 WHO tuberculosis report:key data analysis for China and the global world［J］. Electronic Journal of Emerging Infectious Diseases, 2023, 8(6): 73-78. (In Chinese)
［3］
Mbewana Ntshanka NG, Msagati TAM. Trends and progress on antibiotic-resistant Mycobacterium tuberculosis and genes in relation to human immunodeficiency virus［J］. The Canadian Journal of Infectious Diseases & Medical Microbiology, 2023, 2023: 6659212.
［4］
Outhred AC, Britton PN, Marais BJ. Drug-resistant tuberculosis-primary transmission and management［J］. The Journal of Infection, 2017, 74 Suppl 1: S128-S135.
［5］
Mabhula A, Singh V. Drug-resistance in Mycobacterium tuberculosis: where we stand［J］. MedChemComm, 2019, 10(8): 1342-1360.
［6］
赵雁林，逄宇．结核病实验室检验规程［M］．北京：人民卫生出版社，2015．
Zhao YL, Pang Y. Tuberculosis laboratory test procedures［M］. Beijing: People’s Medical Publishing House, 2015. (In Chinese)
［7］
刘一典．复治肺结核病诊断和治疗专家共识［J］．中国防痨杂志, 2021, 43(12): 1226-1238.
Liu YD. Expert consensus on the diagnosis and treatment of retreated tuberculosis［J］. Chinese Journal of Antituberculosis, 2021, 43(12): 1226-1238. (In Chinese)
［8］
Cardona PJ. Pathogenesis of tuberculosis and other mycobacteriosis［J］. Enfermedades Infecciosas y Microbiologia Clinica, 2018, 36(1): 38-46.
［9］
Liu L, Zhao XJ, Wu XY, et al. Prevalence and molecular characteristics of drug-resistant Mycobacterium tuberculosis in Hainan, China: from 2014 to 2019［J］. BMC Microbiology, 2021, 21(1): 185.
［10］
Kumar V, Jorwal P, Soneja M, et al. Evaluation of rapid diagnostic tests and assessment of risk factors in drug-resistant pulmonary tuberculosis［J］. Journal of Family Medicine and Primary Care, 2020, 9(2): 1028-1034.
［11］
李德富，俞玉琪，卢曲琴，等．江西省耐药结核病治疗现状与抗结核药治疗费用分析［J］．现代预防医学, 2021, 48(18): 3425-3429.
Li DF, Yu YQ, Lu QQ, et al. Analysis of treatment status of drug-resistant tuberculosis and cost of anti-tuberculosis drugs in Jiangxi Province［J］. Modern Preventive Medicine, 2021, 48(18): 3425-3429. (In Chinese)
［12］
Caminero Luna JA, Pérez Mendoza G, Rodríguez de Castro F. Multi-drug resistant tuberculosis, ten years later［J］. Medicina Clinica, 2021, 156(8): 393-401.
［13］
Liebenberg D, Gordhan BG, Kana BD. Drug resistanttuberculosis: Implications for transmission, diagnosis, and disease management［J］. Frontiers in Cellular and Infection Microbiology, 2022, 12: 943545.
［14］
国家呼吸内科医疗质量控制中心，中华医学会结核病学分会，中国防痨协会结核病控制专业分会，等．综合医疗机构肺结核早期发现临床实践指南［J］．中国防痨杂志, 2024, 46(2): 127-140.
National Center for Medical Quality Control of Respiratory Medicine, Tuberculosis Branch of Chinese Medical Association, Tuberculosis Control Branch of Chinese Tuberculosis Association, et al. Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities［J］. Chinese Journal of Antituberculosis, 2024, 46(2): 127-140. (In Chinese)
［15］
包训迪，梁锁，李军，等．2016—2022年安徽省结核病耐药监测结果分析［J］．中国防痨杂志, 2024, 46(5): 531-537.
Bao XD, Liang S, Li J, et al. Analysis ofmycobacterium tuberculosis drug resistance monitoring in Anhui province from 2016 to 2022［J］. Chinese Journal of Antituberculosis, 2024, 46(5): 531-537. (In Chinese)
［16］
白桦，郭婧玮，胡培磊，等．2014—2018年湖南省耐药监测点结核分枝杆菌耐药监测结果分析［J］．中国防痨杂志, 2021, 43(4): 364-369.
Bai H, Guo JW, Hu PL, et al. Analysis ofdrug resistance surveillance results of Mycobacterium tuberculosis in Hu’nan Province from 2014 to 2018［J］. Chinese Journal of Antituberculosis, 2021, 43(4): 364-369. (In Chinese)
［17］
郝金奇，张兰，余艳琴，等．内蒙古地区结核病的耐药现状及影响因素研究［J］．安徽医科大学学报, 2024, 59(3): 515-520.
Hao JQ, Zhang L, Yu YQ, et al. Status quo and influencing factors of drug resistance of tuberculosis in Inner Mongolia［J］. Acta Universitatis Medicinalis Anhui, 2024, 59(3): 515-520. (In Chinese)
［18］
李江红，雷彩英，颜淑萍，等．2015—2022年天水市肺结核患者耐药情况及利福平耐药特征分析［J］．中国防痨杂志, 2024, 46(3): 340-348.
Li JH, Lei CY, Yan SP, et al. Analysis of drug resistance situation results and rifampicin resistance characteristics in pulmonary tuberculosis patients in Tianshui City from 2015 to 2022［J］. Chinese Journal of Antituberculosis, 2024, 46(3): 340-348. (In Chinese)
［19］
潘建华，罗丹，石国民，等．湖南长沙市结核分枝杆菌耐药情况分析［J］．临床肺科杂志, 2016, 21(10): 1751-1753, 1756.
Pan JH, Luo D, Shi GM, et al. Drug resistance analysis onMycobacterium tuberculosis in patients with pulmonary tuberculosis in Changsha area［J］. Journal of Clinical Pulmonary Medicine, 2016, 21(10): 1751-1753, 1756. (In Chinese)
［20］
杨国庆，何杨，杨曦霞，等．2014—2022年德阳市结核分枝杆菌耐药情况分析［J］．预防医学情报杂志, 2024, 40(9): 1173-1178.
Yang GQ, He Y, Yang XX, et al. Analysis on drug resistance of mycobacterium tuberculosis in Deyang City from 2014 to 2022［J］. Journal of Preventive Medicine Information, 2024, 40(9): 1173-1178. (In Chinese)
［21］
黄静静，柯芊羽，侯萍，等．海南省2018—2022年结核分枝杆菌耐药监测分析［J］．中国热带医学, 2024, 24(1): 102-106.
Huang JJ, Ke QY, Hou P, et al. Surveillance of drug resistance to Mycobacterium tuberculosis in Hainan Province,2018-2022［J］. China Tropical Medicine, 2024, 24(1): 102-106. (In Chinese)
2024年第51卷第24期
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doi: 10.20043/j.cnki.MPM.202407522
  • 接收时间：2024-07-29
  • 首发时间：2026-03-18
  • 出版时间：2024-12-25
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  • 收稿日期：2024-07-29
基金
湖南省自然科学基金项目(2021JJ70130)
湖南省卫健委科研项目(D202303086260)
作者信息
    长沙市中心医院检验科（南华大学附属长沙中心医院），湖南 长沙 41004

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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