Alrajhi Abdulrahman A, Abdulwahab Shahab, Almodovar Edna, Al-Abdely Hail M
Section of Infectious Diseases, Department of Pathology & Laboratory Services, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2002 Mar;23(3):305-10.
To identify rates of primary and secondary drug-resistant Mycobacterium tuberculosis and their risk factors from a tertiary-care center in the Kingdom of Saudi Arabia.
Review of microbiological and clinical data of all patients with positive isolates of Mycobacterium tuberculosis between 1995 and 2000 at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Susceptibility to antituberculosis agents was tested in 320 isolates from 320 patients. The median age was 50 years. Pulmonary tuberculosis was diagnosed in 106 (33%) patients, extrapulmonary in 183 (57%), and both in 31 (10%) patients. Two hundred forty-six isolates were sensitive to all 5 first line agents. Resistance to at least one of the first line agents was documented in 36 (11.3%) isolates. For the year 2000, resistance rates increased to 17.6%. Monoresistance was noted in 20 isolates (6.3%) and polyresistance in 16 isolates (5.0%) including 9 multidrug-resistant Mycobacterium tuberculosis isolates (2.8%). Resistance rates for antituberculosis agents are: Isoniazid, 9.1%; Rifampin, 2.8%; Ethambutol, 1.6%; Streptomycin, 5%; Pyrazinamide, 3.6%. Seventy-eight percent of the resistant isolates are considered primary resistance. History of antituberculosis therapy was the only risk factor associated with drug resistant Mycobacterium tuberculosis, odds ratio 19.9 (P< 0.00001). The mean age of patients with resistant isolates was 42 years compared to 49 years in patients with susceptible isolates (P= 0.047).
In a population of mostly Saudi patients, primary and secondary drug-resistant Mycobacterium tuberculosis is relatively low but has increased lately. Previous history of antituberculosis chemotherapy and young age are risk factors identified.
确定沙特阿拉伯王国一家三级医疗中心原发性和继发性耐药结核分枝杆菌的发生率及其危险因素。
回顾1995年至2000年期间沙特阿拉伯王国利雅得法赫德国王专科医院及研究中心所有结核分枝杆菌分离株呈阳性患者的微生物学和临床资料。
对320例患者的320株分离株进行了抗结核药物敏感性检测。中位年龄为50岁。106例（33%）患者诊断为肺结核，183例（57%）为肺外结核，31例（10%）患者两者均有。246株分离株对所有5种一线药物敏感。36株（11.3%）分离株记录到对至少一种一线药物耐药。2000年，耐药率增至17.6%。20株（6.3%）为单耐药，16株（5.0%）为多耐药，其中包括9株耐多药结核分枝杆菌分离株（2.8%）。抗结核药物的耐药率分别为：异烟肼9.1%；利福平2.8%；乙胺丁醇1.6%；链霉素5%；吡嗪酰胺3.6%。78%的耐药分离株被认为是原发性耐药。抗结核治疗史是与耐药结核分枝杆菌相关的唯一危险因素，比值比为19.9（P<0.00001）。耐药分离株患者的平均年龄为42岁，而敏感分离株患者为49岁（P=0.047）。
在以沙特患者为主的人群中，原发性和继发性耐药结核分枝杆菌的发生率相对较低，但最近有所上升。已确定抗结核化疗史和年轻是危险因素。
