Department of Intensive Care Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
Eur J Clin Microbiol Infect Dis. 2010 Nov;29(11):1413-6. doi: 10.1007/s10096-010-1019-7. Epub 2010 Jul 22.
We retrospectively investigated the prevalence of drug resistance in Mycobacterium tuberculosis (MTB) isolates recovered from elderly patients and compared the drug resistance patterns between the elderly (≥65 years old) and adult (15-64 years old) patients. Data on the prevalence of drug resistance in clinical and non-duplicate isolates of MTB recovered from 2000 to 2008 were evaluated. Among the 3,186 non-duplicate MTB isolates found during the study period, 1,497 isolates were recovered from elderly patients. Thirty-eight (2.54%) isolates were multidrug-resistant tuberculosis (MDRTB). The rates of resistance to isoniazid (INH), rifampicin (RIF), ethambutol (EMB), streptomycin (SM), ofloxacin, rifabutin, any one drug-resistant (ADR), and multidrug-resistant (MDR) were significantly lower in isolates from the elderly than from adults (p < 0.05). Significant decreasing trends in resistance rates to EMB, SM, at least any one of the four first-line agents (ADR), and MDRTB were observed (p < 0.05) . In conclusion, elderly patients had a lower rate of anti-TB drug resistance than adults and a decreasing overall trend of anti-TB drug resistance was found in the elderly in recent years, but the higher rate of MDRTB in Taiwan continues to present a challenge for the control of TB in the elderly.
我们回顾性调查了从老年患者中分离的结核分枝杆菌（MTB）分离株的耐药率，并比较了老年（≥65 岁）和成年（15-64 岁）患者之间的耐药模式。评估了 2000 年至 2008 年期间从临床和非重复 MTB 分离株中获得的耐药率数据。在研究期间发现的 3186 个非重复 MTB 分离株中，有 1497 个来自老年患者。38（2.54％）株为耐多药结核病（MDRTB）。与成人相比，老年患者分离株对异烟肼（INH）、利福平（RIF）、乙胺丁醇（EMB）、链霉素（SM）、氧氟沙星、利福布汀、任何一种耐药（ADR）和耐多药（MDR）的耐药率明显较低（p<0.05）。耐药率显著降低的趋势观察到对 EMB、SM、至少四种一线药物中的一种（ADR）和 MDRTB（p<0.05）。结论：老年患者的抗结核药物耐药率低于成人，近年来老年患者的抗结核药物耐药率呈总体下降趋势，但台湾 MDRTB 的高比率仍对老年结核病的控制构成挑战。
