重庆口岸出国移民肺结核监测分析
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摘要
目的掌握重庆口岸出国移民人员活动性肺结核流行现状。方法选取2014—2018年重庆市健康之友国际诊所赴英国及澳大利亚移民体检者中X线胸片异常者,对痰涂片镜检、痰培养及药敏试验结果进行回顾性分析。结果共筛查出176名胸片异常者,男性48.9%,女性51.1%。176名患者涂片镜检均未发现抗酸杆菌,有38例MGIT 960培养阳性,阳性率为21.6%,其中20例为肺结核,18例为非结核分枝杆菌感染;男性较多,主要集中于30岁以下和60岁以上。14例完成药敏检测的病例中,有7例为耐药结核,其中4例为耐多药结核;5种抗结核药物中,利福平的耐药率最高,最低为乙胺丁醇。结论重庆口岸出国移民中菌阳活动性肺结核以涂阴培阳患者为主,耐药率高。今后应加强对胸片异常者的结核分枝杆菌培养。
Objective To understand the prevalence of active pulmonary tuberculosis(PTB) among immigrate applicants in Chongqing port. Methods The cases of immigrants to Britain and Australia with abnormal chest X-ray screening in Chongqing Healthmate International Clinic from 2014 to 2018 were selected as subjects. The results of sputum smear,sputum culture and drug-susceptibility test of these cases were analyzed. Results A total of 176 cases with abnormal chest X-ray were screened. Among them,the males accounted for 48.9% and the females accounted for 51.1%. No smear-positive case was found. There were 38 cases showed cultured positive with MGIT960,the positive rate was 21.6%. Among the 38 cases,20 cases were identified as PTB and 18 cases were identified as non-tuberculosis mycobacterium. The male cases were more than those of the females among the PTB pa-tients,most of the cases were below 30 years or above 60 years old. The drug-susceptibility test was conducted in14 cases,7 of them were drug-resistant tuberculosis and 4 were multidrug-resistant tuberculosis. Among the 5 antituberculosis drugs,rifampicin had the highest drug-resistant rate,and the lowest one was ethambutol. Conclusion The sputum-positive active PTB patients in Chongqing port were mostly smear-negative and culture-positive,with higher drug resistance rate. In the future,we should to strengthen the Mycobacterium tuberculosis culture for the persons with abnormal chest X-ray.
Objective To understand the prevalence of active pulmonary tuberculosis(PTB) among immigrate applicants in Chongqing port. Methods The cases of immigrants to Britain and Australia with abnormal chest X-ray screening in Chongqing Healthmate International Clinic from 2014 to 2018 were selected as subjects. The results of sputum smear,sputum culture and drug-susceptibility test of these cases were analyzed. Results A total of 176 cases with abnormal chest X-ray were screened. Among them,the males accounted for 48.9% and the females accounted for 51.1%. No smear-positive case was found. There were 38 cases showed cultured positive with MGIT960,the positive rate was 21.6%. Among the 38 cases,20 cases were identified as PTB and 18 cases were identified as non-tuberculosis mycobacterium. The male cases were more than those of the females among the PTB pa-tients,most of the cases were below 30 years or above 60 years old. The drug-susceptibility test was conducted in14 cases,7 of them were drug-resistant tuberculosis and 4 were multidrug-resistant tuberculosis. Among the 5 antituberculosis drugs,rifampicin had the highest drug-resistant rate,and the lowest one was ethambutol. Conclusion The sputum-positive active PTB patients in Chongqing port were mostly smear-negative and culture-positive,with higher drug resistance rate. In the future,we should to strengthen the Mycobacterium tuberculosis culture for the persons with abnormal chest X-ray.
引文
[1] World Health Organization. Global tuberculosis report 2017[R].Geniwa:World Health Organization,2017.
[2] Gibney KB,Mihrshahi S,Torresi J,et al. The profile of health problems in African immigrants attending an infectious disease unit in Melbourne,Australia[J]. The American Journal of Tropical Medicine and Hygiene,2009,80(5):805-811.
[3] Raisanen PE,Soini H,Vasankari T,et al. Tuberculosis in immigrants in Finland,1995-2013[J]. Epidemiology and Infection,2016,144(2):425-433.
[4]何冰,谈波,王凌冰,等.关注移民与结核[J].旅行医学科学,2003,9(4):44-45.
[5]中国防痨协会基础专业委员会.结核病诊断实验室检验规程[M].北京:中国教育文化出版社,2006.
[6] World Health Organization. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis[R]. Geniwa:World Health Organization,2014.
[7] Dhawan V,Bown J,Lau A,et al. Towards the elimination of paediatric tuberculosis in high-income,immigrant-receiving countries:a 25-year conventional and molecular epidemiological case study[J]. ERJ Open Research,2018,4(2):102-104.
[8] Verver S,Soolingen D,Borgdorff MW,et al.移民筛查对结核病传播的影响[J].国际结核病与肺部疾病杂志,2002(2):47-54.
[9]余雅,刘英,胡代玉,等.2009-2013年重庆市肺结核疫情特征分析[J].中国防痨杂志,2014,36(12):1036-1042.
[10]全国第五次结核病流行病学抽样调查技术指导组. 2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[11]肖利力,吴思远,何平平,等.北京口岸赴美移民人群结核病监测结果分析[J].中国防痨杂志,2014,36(2):86-92.
[12]吴培丰,张建明,吴健,等.2010—2016年广东口岸赴美移民肺结核筛查情况分析[J].中国国境卫生检疫杂志,2018,41(1):48-51.
[13]孟成艳,周娴,蔡蕾,等.上海口岸赴五国出境人员结核病筛查策略及筛查结果比较[J].中国国境卫生检疫杂志,2016,39(5):352-355.
[14] Zhang D,An J,Wang J,et al. Molecular typing and drug susceptibility of Mycobacterium tuberculosis isolates from Chongqing Municipality,China[J]. Infection,Genetics and Evolution,2013(13):310-316.
[15]王健,方筠,张琳,等.上海出入境人员结核病实验室检测情况分析[J].中国国境卫生检疫杂志,2010,33(1):15-17.
[16] Hirano K,Aono A,Takahashi M,et al. Mutations including IS6110 insertion in the gene encoding the MPB64 protein of Capilia TB-negative Mycobacterium tuberculosis isolates[J].Journal of Clinical Microbiology,2004,42(1):390-392.
[17]李国利,张灵霞,陈澎.对硝基苯甲酸生长试验鉴别结核与非结核分枝杆菌应用评价[J].临床肺科杂志,2009,14(12):1648-1649.
[18] Yam WC,Yuen KY,Kam SY,et al. Diagnostic application of genotypic identification of mycobacteria[J]. Journal of Medical Microbiology,2006,55(5):529-536.
[19]李同心,何瑛,周刚,等.全血γ-干扰素释放试验在结核病辅助诊断中的价值[J].中国防痨杂志,2016,38(8):623-629.
[2] Gibney KB,Mihrshahi S,Torresi J,et al. The profile of health problems in African immigrants attending an infectious disease unit in Melbourne,Australia[J]. The American Journal of Tropical Medicine and Hygiene,2009,80(5):805-811.
[3] Raisanen PE,Soini H,Vasankari T,et al. Tuberculosis in immigrants in Finland,1995-2013[J]. Epidemiology and Infection,2016,144(2):425-433.
[4]何冰,谈波,王凌冰,等.关注移民与结核[J].旅行医学科学,2003,9(4):44-45.
[5]中国防痨协会基础专业委员会.结核病诊断实验室检验规程[M].北京:中国教育文化出版社,2006.
[6] World Health Organization. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis[R]. Geniwa:World Health Organization,2014.
[7] Dhawan V,Bown J,Lau A,et al. Towards the elimination of paediatric tuberculosis in high-income,immigrant-receiving countries:a 25-year conventional and molecular epidemiological case study[J]. ERJ Open Research,2018,4(2):102-104.
[8] Verver S,Soolingen D,Borgdorff MW,et al.移民筛查对结核病传播的影响[J].国际结核病与肺部疾病杂志,2002(2):47-54.
[9]余雅,刘英,胡代玉,等.2009-2013年重庆市肺结核疫情特征分析[J].中国防痨杂志,2014,36(12):1036-1042.
[10]全国第五次结核病流行病学抽样调查技术指导组. 2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[11]肖利力,吴思远,何平平,等.北京口岸赴美移民人群结核病监测结果分析[J].中国防痨杂志,2014,36(2):86-92.
[12]吴培丰,张建明,吴健,等.2010—2016年广东口岸赴美移民肺结核筛查情况分析[J].中国国境卫生检疫杂志,2018,41(1):48-51.
[13]孟成艳,周娴,蔡蕾,等.上海口岸赴五国出境人员结核病筛查策略及筛查结果比较[J].中国国境卫生检疫杂志,2016,39(5):352-355.
[14] Zhang D,An J,Wang J,et al. Molecular typing and drug susceptibility of Mycobacterium tuberculosis isolates from Chongqing Municipality,China[J]. Infection,Genetics and Evolution,2013(13):310-316.
[15]王健,方筠,张琳,等.上海出入境人员结核病实验室检测情况分析[J].中国国境卫生检疫杂志,2010,33(1):15-17.
[16] Hirano K,Aono A,Takahashi M,et al. Mutations including IS6110 insertion in the gene encoding the MPB64 protein of Capilia TB-negative Mycobacterium tuberculosis isolates[J].Journal of Clinical Microbiology,2004,42(1):390-392.
[17]李国利,张灵霞,陈澎.对硝基苯甲酸生长试验鉴别结核与非结核分枝杆菌应用评价[J].临床肺科杂志,2009,14(12):1648-1649.
[18] Yam WC,Yuen KY,Kam SY,et al. Diagnostic application of genotypic identification of mycobacteria[J]. Journal of Medical Microbiology,2006,55(5):529-536.
[19]李同心,何瑛,周刚,等.全血γ-干扰素释放试验在结核病辅助诊断中的价值[J].中国防痨杂志,2016,38(8):623-629.