Wang D M, Li Q F, Zhu M, Xu Y H, Luo J, Li Y J, Zhong J, Wu Z J
Public Health Clinical Centers of Chengdu, Clinical Laboratory, Chengdu 610066, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2017 Aug 12;40(8):592-595. doi: 10.3760/cma.j.issn.1001-0939.2017.08.010.
To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years.The epidemiological data, infection and drug resistance were analyzed statistically. There were 21 036 cases of mycobacterial culture from January 2013 to December 2015, of which 7 119 were positive(33.8%). Extrapulmonary tuberculosis was found in 6 107 cases, of which 896 were positive, accounting for 12.6% of the positive cases(896/7 119). Culture-positive cases of extra-pulmonary tuberculosis showed a rising trend from 2013 to 2015 (=174, 310, 421, respectively), and the annual average increasing rate was over 50%.Cases were distributed at younger ages (21-40 years), with an average age of 34 years.There were more male patients, with a male to female ratio of 2.1∶1. The most common site of extrapulmonary tuberculosis was the bone(62/243, 25.5%), followed by lymph node(283/1 297, 21.8%), pleural(289/1 840, 15.7%), urinary tract(63/452, 13.9%), peritoneum(41/303, 13.5%), meningeal(156/1 915, 8.1%)and other types of tuberculosis(2/57, 3.5%). Drug sensitivity test of 896 extrapulmonary tuberculosis strains showed that the resistance rate (from high to low) was in the order of isoniazid, rifampicin, streptomycin, ofloxacin, ciprofloxacin, amikacin, capreomycin and ethambutol. Multidrug-resistant(MDR)and extremely-drug resistant (XDR) rate was 9.7 %(87/896)and 2.0%(17/896)respectively. Cases of extrapulmonary tuberculosis sent for bacterial culture and the positive rate showed a rising trend by years in Chengdu area.The drug resistance level was higher than that reported both in China and abroad.The prevention and treatment of extrapulmonary tuberculosis should be strengthened in this area.
分析肺外结核的感染情况及耐药性，为结核病的防治提供参考依据。回顾性收集2013年1月至2015年12月成都市公共卫生临床中心6107例疑似肺外结核病例，包括淋巴结结核、结核性胸膜炎、结核性腹膜炎、结核性脑膜炎、泌尿系统结核及骨结核。其中男性4033例，女性2074例，平均年龄37岁。对其流行病学资料、感染情况及耐药性进行统计学分析。2013年1月至2015年12月共进行分枝杆菌培养21036例，其中阳性7119例（33.8%）。肺外结核6107例，其中阳性896例，占阳性病例的12.6%（896/7119）。肺外结核培养阳性病例数2013年至2015年呈上升趋势（分别为174例、310例、421例），年平均增长率超过50%。病例以中青年（21～40岁）为主，平均年龄34岁。男性患者多于女性，男女比例为2.1∶1。肺外结核最常见部位为骨（62/243，25.5%），其次为淋巴结（283/1297，21.8%）、胸膜（289/1840，15.7%）、泌尿系统（63/452，13.9%）、腹膜（41/303，13.5%）、脑膜（156/1915，8.1%）及其他类型结核（2/57，3.5%）。896株肺外结核菌株药物敏感试验结果显示，耐药率（由高到低）依次为异烟肼、利福平、链霉素、氧氟沙星、环丙沙星、阿米卡星、卷曲霉素及乙胺丁醇。耐多药（MDR）率和广泛耐药（XDR）率分别为9.7%（87/896）和2.0%（17/896）。成都地区送检的肺外结核病例及阳性率呈逐年上升趋势。耐药水平高于国内外报道。该地区应加强肺外结核的防治工作。
