Alberte-Castiñeiras A, Brezmes-Valdivieso M F, Campos-Bueno A, Montes-Martinez I, López-Medrano R, Avellaneda C, Pérez-Pascual P, Della-Latta P
Departamento de Microbiología, Hospital del Río Hortega, Rondilla de Santa Teresa, 9 E-47010 Valladolid, Spain.
Int J Tuberc Lung Dis. 2006 May;10(5):554-8.
During 1996-2000, a regional anti-tuberculosis drug resistance survey was conducted in Castilla-León, Spain.
To determine the incidence of drug-resistant tuberculosis (TB) in newly treated human immunodeficiency virus (HIV) negative and HIV-positive TB patients.
Nine hundred and eighty-five Mycobacterium tuberculosis strains isolated from HIV-negative (926) and HIV-positive (59) patients were studied (one strain per patient). Univariate and multivariate analyses were used to determine the prevalence of drug resistance in high-risk groups.
Thirty-eight isolates (3.8%) showed resistance to one of the following drugs: streptomycin (S), isoniazid (H), rifampicin (R) or ethambutol (E). Of these, 36 (3.9%) were from HIV-negative and 2 (3.4%) from HIV-positive patients. The rate of drug resistance among HIV-negative patients was 1.2%, 2.0%, 0.3% and 0.8%, respectively, for S, H, R and E, and for HIV-positive patients it was 3.4%, 0%, 0% and 1.7%. Among the HIV-negative patients, monoresistance was observed in 32 (3.4%) strains and resistance to both H and R (multi-drug resistance) was detected in one.
The incidence of primary drug resistance in the surveyed area was low and increased resistance was not observed in the HIV-positive group (P = 0.99). Routine surveillance of drug resistance is recommended by the TB control programme in representative patient populations to optimise treatment regimens.
1996年至2000年期间，在西班牙卡斯蒂利亚-莱昂进行了一项区域性抗结核药物耐药性调查。
确定新治疗的人类免疫缺陷病毒（HIV）阴性和HIV阳性结核病（TB）患者中耐多药结核病的发病率。
对从HIV阴性（926例）和HIV阳性（59例）患者中分离出的985株结核分枝杆菌菌株进行研究（每位患者一株菌株）。采用单因素和多因素分析来确定高危人群中的耐药率。
38株分离菌（3.8%）对以下一种药物耐药：链霉素（S）、异烟肼（H）、利福平（R）或乙胺丁醇（E）。其中，36株（3.9%）来自HIV阴性患者，2株（3.4%）来自HIV阳性患者。HIV阴性患者中，S、H、R和E的耐药率分别为1.2%、2.0%、0.3%和0.8%，HIV阳性患者中分别为3.4%、0%、0%和1.7%。在HIV阴性患者中，32株（3.4%）菌株为单耐药，1株检测到对H和R均耐药（耐多药）。
调查地区的原发性耐药发病率较低，HIV阳性组未观察到耐药率增加（P = 0.99）。结核病控制项目建议对有代表性的患者群体进行耐药性常规监测，以优化治疗方案。
