Campos Pablo E, Suarez Pedro G, Sanchez Jorge, Zavala David, Arevalo Jorge, Ticona Eduardo, Nolan Charles M, Hooton Thomas M, Holmes King K
University of Washington, Seattle, Washington 98104, USA.
Emerg Infect Dis. 2003 Dec;9(12):1571-8. doi: 10.3201/eid0912.020731.
During 1999 to 2000, we identified HIV-infected persons with new episodes of tuberculosis (TB) at 10 hospitals in Lima, Peru, and a random sample of other Lima residents with TB. Multidrug-resistant (MDR)-TB was documented in 35 (43%) of 81 HIV-positive patients and 38 (3.9%) of 965 patients who were HIV-negative or of unknown HIV status (p<0.001). HIV-positive patients with MDR-TB were concentrated at three hospitals that treat the greatest numbers of HIV-infected persons with TB. Of patients with TB, those with HIV infection differed from those without known HIV infection in having more frequent prior exposure to clinical services and more frequent previous TB therapy or prophylaxis. However, MDR-TB in HIV-infected patients was not associated with previous TB therapy or prophylaxis. MDR-TB is an ongoing problem in HIV-infected persons receiving care in public hospitals in Lima and Callao; they represent sentinel cases for a potentially larger epidemic of nosocomial MDR-TB.
1999年至2000年期间，我们在秘鲁利马的10家医院中确定了患有新发结核病（TB）的HIV感染者，以及利马其他患有结核病的居民的随机样本。81例HIV阳性患者中有35例（43%）记录有多药耐药（MDR）-TB，965例HIV阴性或HIV感染状况未知的患者中有38例（3.9%）记录有多药耐药-TB（p<0.001）。患有MDR-TB的HIV阳性患者集中在三家治疗HIV感染结核病患者数量最多的医院。在患有结核病的患者中，HIV感染者与未知HIV感染状况者的不同之处在于，前者更频繁地接受过临床服务，且更频繁地接受过先前的结核病治疗或预防。然而，HIV感染患者中的MDR-TB与先前的结核病治疗或预防无关。在利马和卡亚俄的公立医院接受治疗的HIV感染者中，MDR-TB是一个持续存在的问题；他们代表了潜在规模更大的医院内MDR-TB流行的哨点病例。
