2015-2019 年西安市 680 例耐多药结核病患者耐药情况分析

Objective A retrospective analysis of drug susceptibility test (DST) results of multidrug-resistant tuberculosis(MDR-TB) patients was carried out to provide evidence for guiding clinical drug administration for MDR-TB patients. Methods All of 680 MDR-TB patients in Xi'an City from 2015 to 2019 were selected as study subjects. The DST results of ethambutol (EMB), streptomycin (Sm), protionamide (Pto), amikacin (Am), capreomycin (Cm), P-aminosalicylic acid (PAS), levofloxacin (Lfx) and moxifloxacin (Mfx) were collected and analyzed. Results (1)The rates of resistance to different drugs could be listed from high to low as: Sm (85.7% (583/680)), Lfx (40.1% (273/680)), EMB (37.5% (255/680)), Mfx (31.3% (213/680)), PAS (14.4% (98/680)), Pto (4.6% (31/680)), Am (4.4% (30/680)), and Cm (4.3% (29/680)); (2)The rates of resistance to several second-line anti-tuberculosis drugs decreased from 2015 to 2019: Am (from 6.9% decreased to 3.0%, (Equation presented), Pas (Equation presented). (3)Cross resistance of second-line anti-tuberculosis drugs: among 30 cases resistant to Am, 21 (70.0%) cases were resistant to Cm; in 29 cases resistant to Cm, 21 (72.4%) cases were resistant to Am: 205 (75.1%) cases were resistant to Mfx in 273 Lfx-resistant cases, 205 (96.2%) cases were resistant to Lfx in 213 Mfx-resistant cases. Conclusion In these 5 years, MDR-TB patients in Xi'an City kept a high resistance rate to EMB and Sm. The drug resistance rates of second-line anti-tuberculosis drugs decreased, but we still need to pay attention to the high resistance rate of quinolone. Those resistance rates to different drug and high cross-resistance rate among second-line anti-tuberculosis drugs should be considered when selecting drugs.