Chuchottaworn Charoen
Division of Respiratory Medicine, Chest Disease Institute, Ministry of Public Health, Nonthaburi, Thailand.
J Med Assoc Thai. 2010 Jan;93(1):34-7.
To determine prevalence of extensively drug resistant tuberculosis (XDR-TB) in Chest Disease Institute. World Health Organization has given the definition of XDR-TB as multi-drug resistant tuberculosis which also resists fluoroquinolone and aminoglycoside.
The present study was a retrospective review and conducted at Microbiology Unit, Chest Disease Institute. Drug susceptibility testing against fluoroquinolone and aminoglycoside have been done routinely since 1997. Laboratory results were studied to find XDR-TB patients and medical record information were reviewed. Laboratory results in 2006-2007 were not completed so were not included in the review.
The result of the present study showed that from 1997 to 2005. 10,289 patients were tested for drug susceptibility. XDR-TB was found in 39 patients. Prevalence of XDR-TB was 6, 6, 9, 4, 3, 3, 2, 4 and 2 patients from 1997-2005 respectively. Most of XDR-TB patients were also resistant to Streptomycin and 39% resistant to Ethambutol. No data of resistance to second line drugs of XDR-TB was done in the present study.
The present study confirmed the existing of XDR-TB in Thai patient for a long time but not in increasing rate. The authorized TB Control organization should take XDR-TB as an important problem and developed capacity of tuberculosis laboratory in order to be able to diagnose XDR-TB.
确定胸科疾病研究所广泛耐药结核病（XDR-TB）的患病率。世界卫生组织对XDR-TB的定义为对氟喹诺酮类和氨基糖苷类耐药的耐多药结核病。
本研究为回顾性研究，在胸科疾病研究所微生物科开展。自1997年起常规进行针对氟喹诺酮类和氨基糖苷类的药敏试验。研究实验室结果以找出XDR-TB患者，并查阅病历信息。2006 - 2007年的实验室结果未完成，因此未纳入本回顾研究。
本研究结果显示，1997年至2005年期间，10289例患者接受了药敏试验。发现39例XDR-TB患者。1997年至2005年期间XDR-TB的患病率分别为6例、6例、9例、4例、3例、3例、2例、4例和2例。大多数XDR-TB患者也对链霉素耐药，39%对乙胺丁醇耐药。本研究未提供XDR-TB患者对二线药物耐药的数据。
本研究证实泰国患者中存在XDR-TB已有很长时间，但患病率未呈上升趋势。官方结核病控制组织应将XDR-TB视为一个重要问题，并提高结核病实验室的能力，以便能够诊断XDR-TB。
