Sosna J, Shulimzon T, Roznman J, Lidgi M, Lavy A, Ben-Dov I Z, Ben-Dov I
Department of Radiology, Haddasha University Medical Center, Jerusalem, Israel.
Int J Tuberc Lung Dis. 1999 Aug;3(8):689-94.
Drug-resistant tuberculosis was uncommon in Israel until 1985, when the waves of immigration began. We studied the incidence and clinical course of resistant pulmonary tuberculosis nationwide.
Isolates of Mycobacterium tuberculosis between 1985 and 1994 were surveyed. Data on 150 patients with resistance and 110 patients with drug-sensitive disease were reviewed. Ethnic origin, type of resistance, radiological findings and outcome were analysed.
In total, 16.7% of the isolates showed resistance to at least one drug; 58% had resistance to multiple drugs. In 67% of the patients the resistance was primary. Most patients were immigrants from the former USSR and from Ethiopia; none were Israeli-born Jews. Mortality with resistance was 10%, and was highest (14%) with multiple drug resistance. Mortality among drug-resistant cases was lowest (3%) among Ethiopian Jews. Cavities and extensive disease were more common with drug resistance.
Drug resistance has become relatively common in Israel due to immigration from the former USSR and Ethiopia. It is more extensive radiologically and carries a poorer outcome.
在1985年移民潮开始之前，耐药结核病在以色列并不常见。我们研究了全国耐药性肺结核的发病率及临床病程。
对1985年至1994年间结核分枝杆菌的分离株进行调查。回顾了150例耐药患者和110例药物敏感疾病患者的数据。分析了种族来源、耐药类型、影像学表现及转归。
总体而言，16.7%的分离株对至少一种药物耐药；58%对多种药物耐药。67%的患者耐药为原发性。大多数患者是来自前苏联和埃塞俄比亚的移民；没有以色列出生的犹太人。耐药患者的死亡率为10%，多重耐药患者死亡率最高（14%）。埃塞俄比亚犹太人中耐药病例的死亡率最低（3%）。耐药患者中出现空洞和广泛病变更为常见。
由于来自前苏联和埃塞俄比亚的移民，耐药性在以色列已变得相对普遍。其影像学表现更为广泛，预后较差。
