印度尼西亚巴布亚省米米卡县一项基于社区的结核病药物敏感性研究。

A community-based TB drug susceptibility study in Mimika District, Papua Province, Indonesia.

作者信息

Kelly P M, Ardian M, Waramori G, Anstey N M, Syahrial H, Tjitra E, Bastian I, Maguire G P, Lumb R

机构信息

Menzies School of Health Research, Darwin, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.

出版信息

Int J Tuberc Lung Dis. 2006 Feb;10(2):167-71.

PMID:16499255

Abstract

SETTING

A district level tuberculosis (TB) control programme in Papua Province, Indonesia.

OBJECTIVE

To determine the nature and extent of drug-resistant TB in newly diagnosed sputum smear-positive patients.

METHODS

Sputum was collected from previously untreated smear-positive pulmonary TB patients diagnosed in the district over a 10-month period. Sputum specimens were processed and inoculated into a BACTEC MGIT960 tube. Isolates were identified by Ziehl-Neelsen staining, hybridisation with nucleic acid probes and biochemical investigations. Susceptibility testing was performed using the radiometric proportion method. Pyrazinamide testing was performed using the Wayne indirect method.

RESULTS

One hundred and seven patients had sputum sent to a reference laboratory; 101 (94.4%) were culture-positive for Mycobacterium tuberculosis, with 87 (86.1%) fully sensitive to first-line anti-tuberculosis drugs. Two per cent were multidrug-resistant (MDR-TB) and 12 (11.9%) had other drug resistance. Each of the MDR-TB isolates was susceptible to amikacin, capreomycin, ciprofloxacin and para-aminosalicylic acid (PAS), but were resistant to rifabutin. One isolate was also resistant to ethionamide.

CONCLUSIONS

MDR-TB is present in Indonesia but is not a major problem for TB control in this district. Generalisability to other districts in Indonesia, particularly large urban areas, needs to be confirmed by future studies.

摘要

背景

印度尼西亚巴布亚省的一个区级结核病控制项目。

目的

确定新诊断的痰涂片阳性患者中耐多药结核病的性质和程度。

方法

在10个月的时间里，从该地区先前未接受治疗的涂片阳性肺结核患者中收集痰液。对痰液标本进行处理并接种到BACTEC MGIT960管中。通过萋尼氏染色、核酸探针杂交和生化检查对分离株进行鉴定。采用放射比例法进行药敏试验。采用韦恩间接法进行吡嗪酰胺试验。

结果

107例患者的痰液被送往参考实验室；101例（94.4%）结核分枝杆菌培养阳性，其中87例（86.1%）对一线抗结核药物完全敏感。2%为耐多药（MDR-TB），12例（11.9%）有其他耐药情况。每株耐多药结核分枝杆菌分离株对阿米卡星、卷曲霉素、环丙沙星和对氨基水杨酸（PAS）敏感，但对利福布汀耐药。1株分离株还对乙硫异烟胺耐药。