Lung Infection and Immunity Unit, Department of Medicine, University of Cape Town, South Africa.
Trop Med Int Health. 2010 Oct;15(10):1179-84. doi: 10.1111/j.1365-3156.2010.02590.x.
To determine the clinical profile and outcomes of health care workers (HCWs) with extensively drug resistant tuberculosis (XDR-TB) in the Eastern and Western Cape Provinces of South Africa.
Retrospective case record review of 334 patients with XDR-TB reported during the period 1996-2008 from Western and Eastern Cape Province, Cape Town, South Africa. Case records of HCWs with XDR-TB were analysed for clinical and microbiological features, and treatment outcomes.
From 334 case records of patients with XDR-TB, 10 HCWs were identified. Eight of ten were HIV-uninfected, and four of 10 had died of XDR-TB despite treatment. All 10 HCWs had received an average of 2.4 courses of TB treatment before being diagnosed as XDR-TB.
In the Eastern and Western Cape provinces of South Africa XDR-TB affects HCWs, is diagnosed rather late, does not appear to be related to HIV status and carries a high mortality. There is an urgent need for the South African government to implement WHO infection control recommendations and make available rapid drug susceptibility testing for HCWs with suspected multidrug-resistant (MDR)/XDR-TB. Further studies to establish the actual risk and sources of infection (nosocomial or community) are required.
确定南非东开普省和西开普省卫生保健工作者（HCWs）广泛耐药结核病（XDR-TB）的临床特征和结局。
对 1996 年至 2008 年期间南非开普敦西开普省和东开普省报告的 334 例 XDR-TB 患者的回顾性病历进行回顾。分析 XDR-TB 患者的临床和微生物学特征以及治疗结局。
从 334 例 XDR-TB 患者的病历中，确定了 10 名 HCWs。10 名患者中有 8 名未感染 HIV，尽管接受了治疗，但其中有 4 名仍死于 XDR-TB。10 名 HCWs 中有 4 名在被诊断为 XDR-TB 之前平均接受了 2.4 个疗程的结核病治疗。
在南非东开普省和西开普省，XDR-TB 影响 HCWs，诊断较晚，似乎与 HIV 状况无关，死亡率很高。南非政府迫切需要实施世卫组织感染控制建议，并为疑似耐多药/广泛耐药结核病（MDR/XDR-TB）的 HCWs 提供快速药物敏感性检测。需要进一步研究以确定实际的感染风险和来源（医院内或社区）。
