Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: 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. Results: 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 (n=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. Conclusions: 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.
目的： 分析成都地区近年来肺外结核患者MTB的感染及耐药情况，为结核病的防控和诊疗提供依据。 方法： 回顾性收集分析四川省成都市公共卫生临床医疗中心和成都各个防控督导点2013年1月至2015年12月组织来源为淋巴结、胸膜、腹膜、脑、泌尿系统、骨等肺外结核病例6 107例，其中男4 033例，女2 074例，年龄1～91岁，平均37岁。对其流行病学资料、感染和耐药情况采用SPSS 18.0软件进行统计分析，计数资料统计描述采用百分率(%)，计量资料统计描述采用x±s表示。 结果： 成都地区2013年1月至2015年12月行MTB培养的21 036例患者中，培养阳性(培阳)7 119例(33.8%)，其中肺外结核6 107例中阳性896例，肺外结核培阳病例占全部培阳病例的12.6%(896/7 119)。2013—2015年肺外结核培阳病例呈逐年上升趋势，年平均递增率超过50%，病例分布以21～40岁为主(46.8%，419/896)；男性多于女性，男女比例为2.1∶1，平均年龄34岁。在淋巴结、胸膜、腹膜、脑膜、泌尿系统、骨和其他类型肺外结核病例中，骨结核病例培养阳性率最高(62/243，25.5%)，其次为淋巴结(283/1 297，21.8%)、胸膜(289/1 840，15.7%)、泌尿系统(63/452，13.9%)、腹膜(41/303，13.5%)、脑膜(156/1 915，8.1%)和其他类型结核(2/457，3.5%)；896例肺外结核病患者分离的MTB菌株对8种抗结核药的药物敏感度试验结果显示其耐药性从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。其耐多药和广泛耐药MTB的平均分离率分别为9.7%(87/896)和2.0%(17/896)。 结论： 成都地区近年来肺外结核的标本送检率和阳性检出率均呈逐年上升趋势，耐药率高于国内外研究水平，本地区肺外结核的防控和诊疗工作应进一步受到重视。.
Keywords: Drug resistance; Mycobacterium tuberculosis; Tuberculosis.