Bone And Joint Tuberculosis Drug Resistance Change,cause Analysis And Countermeasures

Objective: Discussion and reasons analysis for changes of bone and joint tuberculosis resistant types,in addition, discussion for the curative effect and safety of individualized treatment after Bone and joint tuberculosis operation. Methods: From 2004 to 2013, Bone and joint tuberculosis patient specimens were collected in Xinjiang Autonomous Region Chest hospital, the Mycobacterium tuberculosis culture and drug susceptibility testing were done, the change reasons of drug resistance type and rate were analyzed. 94 cases of bone and joint tuberculosis were included in Sixth Affiliated Hospital of Xinjiang Medical University, which were divided into standard and individualized treatment group comparing the efficacy and safety between the two groups. Results: In the 1158 specimens, 592 were positive and the positive rate was 51.1%, drug-resistant strain were254 cases, the total resistance rates was 42.9%, multi-drug resistant strain were 75 cases,the total multi-drug resistant rate was 12.7%. The total resistance rate is on the increase,the resistance rate of rifampicin is on the increase, the multi-drug resistant strain is on the increase. The resistance rate is H(isoniazid)> S(Streptomycin)> R(rifampicin)>E(Ethambutol hydrochloride). 33 cases were cured in Standard treatment group(cure rate:70.2%), 41 cases were cured in individualized treatment group(cure rate:87.2%),there was significant difference between the two groups(P < 0.05).The adverse reaction of Standardized treatment and individualized treatment group were 11 cases(adverse reaction rate:23.4%) and 3 cases(adverse reaction rate:6.4%), there was significant difference between the two groups(P < 0.05). Conclusion: The total resistant rate is on the increase. The situation of multi-drug resistant is serious, which is connected with irregular medicine usage. We need supervise more about the tuberculosis prevention,control and treatment. The bone and joint tuberculosis with multi-drug resistant should use individual treatment. The individualized treatment after Bone andjoint tuberculosis operation has higher cure rate and less adverse reaction than standard treatment.