Lumb Richard, Bastian Ivan, Dawson David, Gilpin Chris, Haverkort Frank, James Greg, Sievers Aina
Infectious Diseases Laboratories, Institute of Medical and Veterinary Science, Adelaide, South Australia, Australia.
Commun Dis Intell Q Rep. 2003;27(2):173-80. doi: 10.33321/cdi.2003.27.41.
The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new cases of disease caused by Mycobacterium tuberculosis complex in the year 2001. A total of 771 cases were identified, representing an annual reporting rate of 4.0 cases of laboratory-confirmed tuberculosis per 100,000 population. The predominant specimen type was sputum, (n=369) and a further 111 were collected at bronchoscopy. Smears were positive for 214 of 369 (58.0%) sputum and 42 of 111 (37.8%) bronchoscopy specimens respectively. Seven children (male n=5, female n=2) under 10 years of age had bacteriologically confirmed tuberculosis. A total of 69 isolates (8.9%), comprising 67 M. tuberculosis, one M. africanum, and one M. bovis, were resistant to at least one of the anti-tuberculosis agents. Excluding the M. bovis isolate, 61 of 64 (93.5%) were classified as having initial resistance, three had acquired resistance, and no data were available on the presence or absence of previous treatment for four patients. Resistance to at least isoniazid and/or rifampicin was noted for 67 isolates (8.7%), with resistance to both isoniazid and rifampicin (i.e. defined as multidrug-resistant disease) observed in 12 (1.6%) isolates. All of the multidrug-resistant isolates were M. tuberculosis, 10 were from the respiratory tract. The country of birth was known for 63 of 68 (92.6%) patients with a drug-resistant strain of M. tuberculosis or M. africanum; five were Australian-born and 58 (92.1%) had migrated from a total of 22 countries. One hundred and seven respiratory specimens had a nucleic acid amplification testing performed; 89 of 90 (98.9%) smear positives were nucleic acid amplification testing positive, whilst only 13 of 17 (76.5%) smear negative specimens were nucleic acid amplification testing positive. The 2001 laboratory data reveals a stable incidence rate and level of drug resistance in isolates from Australian patients with tuberculosis.
澳大利亚分枝杆菌参考实验室网络收集并分析了2001年结核分枝杆菌复合群所致新发病例的实验室数据。共识别出771例病例，相当于每10万人口中实验室确诊结核病的年报告率为4.0例。主要标本类型为痰液（n = 369），另有111例在支气管镜检查时采集。369份痰液标本中有214份（58.0%）涂片呈阳性，111份支气管镜标本中有42份（37.8%）涂片呈阳性。7名10岁以下儿童（男5名，女2名）经细菌学确诊患有结核病。共有69株分离菌（8.9%），包括67株结核分枝杆菌、1株非洲分枝杆菌和1株牛分枝杆菌，对至少一种抗结核药物耐药。排除牛分枝杆菌分离株后，64株中有61株（93.5%）被归类为初始耐药，3株为获得性耐药，4例患者有无既往治疗情况的数据缺失。67株分离菌（8.7%）对至少异烟肼和/或利福平耐药，12株（1.6%）分离菌对异烟肼和利福平均耐药（即定义为耐多药疾病）。所有耐多药分离菌均为结核分枝杆菌，10株来自呼吸道。68例结核分枝杆菌或非洲分枝杆菌耐药菌株患者中，63例（92.6%）的出生国家已知；5例出生于澳大利亚，58例（92.1%）来自22个国家。107份呼吸道标本进行了核酸扩增检测；90份涂片阳性标本中有89份（98.9%）核酸扩增检测呈阳性，而17份涂片阴性标本中只有13份（76.5%）核酸扩增检测呈阳性。2001年的实验室数据显示，澳大利亚结核病患者分离株的发病率和耐药水平稳定。
