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Prevalence and patterns of drug resistance among pulmonary tuberculosis patients in Hangzhou, China

机译：杭州市肺结核患者的耐药性现状和模式

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摘要

To evaluate prevalence and patterns of drug resistance among pulmonary tuberculosis (TB) patients in Hangzhou City, China. Sputum samples of smear positive TB patients enrolled in 2011 and 2015 were collected and tested for drug susceptibility, and demographic and medical record data were extracted from the electronic database of China Information System for Disease Control and Prevention. Chi-square test was used to compare drug resistance prevalence between new and treated patients and between male and female patients, and Chi-square test for trend was used to compare the prevalence over calendar years 2011 and 2015. Of 1326 patients enrolled in 2015, 22.3% had resistance to any first-line anti-TB drugs and 8.0% had multi-drug resistance (MDR); drug resistance rates among previously treated cases were significantly higher than among new cases. Significant declines of resistance to isoniazid, rifampin, ethambutol and streptomycin, and MDR from 2011 to 2015 were observed among previously treated patients, while a significant decline of resistance to rifampin was observed among new cases. While the prevalence of acquired drug resistance decreased due to due to implementation of DOTS-Plus program, the prevalence of primary drug resistance due to transmission remained high. Greater efforts should be made to screen drug resistance for case finding and to reduce transmission through improving the treatment and management of drug-resistant patients.
机译：目的评估杭州市肺结核（TB）患者的耐药性和耐药模式。收集2011年和2015年入选的涂阳肺结核患者的痰标本并进行药敏测试，并从中国疾病预防控制信息系统的电子数据库中提取人口统计和病历数据。卡方检验用于比较新患者和接受治疗的患者之间以及男性和女性患者之间的耐药性患病率，卡方检验趋势用​​于比较2011和2015日历年的患病率。2015年招募的1326例患者中， 22.3％的人对任何一线抗结核药物有耐药性，而8.0％的人对多药耐药性（MDR）;先前治疗病例中的耐药率显着高于新病例。在2011年至2015年期间，先前接受治疗的患者对异烟肼，利福平，乙胺丁醇和链霉素以及MDR的耐药性显着下降，而在新病例中，对利福平的耐药性显着下降。虽然由于实施DOTS-Plus计划而使获得性耐药的发生率下降，但由于传播引起的原发耐药性的发生率仍然很高。应加大力度筛选耐药性以寻找病例，并通过改善耐药性患者的治疗和管理来减少传播。

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