Drug resistance analysis in 243 patients with sputum smear-positive pulmonary tuberculosis

Hou Jing; Liu Gang; Han Jun; Fang Xuehui

doi:10.3760/j.issn.1673-4777.2019.02.016

Abstract：Objective To analyze the drug resistance of sputum smear-positive pulmonary tuberculosis in 243 patients and provide scientific evidence for reasonable treatment of drug-resistant tuberculosis.Methods From January to December 2016,243 patients with sputum smear-positive pulmonary tuberculosis were enrolled at Anhui Chest Hospital.Drug sensitivity tests of 10 anti-tuberculosis drugs (isoniazid,rifampicin,streptomycin,ethambutol,levofloxacin,amikacin,capreomycin,protionamide,sodium aminosalicylate and rifametine) were conducted after sputum separation and culture.Results of drug resistance were analyzed.Results Drug resistance rate of all patients was 41.6％ (101/243).Rates of drug resistance,multi-drug resistance,first-line anti-tuberculosis drug resistance and second-line anti-tuberculosis drug resistance in retreated patients were higher than those in newly diagnosed patients[68.7％ (68/99) vs 22.9％ (33/144),33.3％ (33/99) vs 2.8％ (4/144),63.6％ (63/99) vs 14.6％ (21/144),63.6％ (63/99) vs 18.1％ (26/144)] (all P ＜0.001).Eighty-four patients were resistant to first-line anti-tuberculosis drugs,among them 37 patients presented multi-drug resistance;the order of resistance rates was rifampicin ＞ streptomycin ＞ isoniazid ＞ ethambutol.Eighty-nine patients were resistant to second-line anti-tuberculosis drugs;the order of resistance rates was rifapentine ＞ protionamide =levofloxacin ＞ amikacin ＞capreomycin ＞ sodium aminosalicylate.Conclusion Tuberculosis,especially drug-resistant tuberculosis is a big clinical problem;ethambutol,capreomycin,amikacin and sodium aminosalicylate show significant anti-tuberculous values;the drug resistance situation of retreatment of tuberculosis is severe.