Research Institute of Tuberculosis, Tokyo, Japan.
Int J Tuberc Lung Dis. 2010 Nov;14(11):1418-23.
Kathmandu Valley urban area, Nepal.
To study the probabilities of failure and relapse and of amplifying drug resistance to isoniazid (INH) and rifampicin (RMP) after the Category II retreatment regimen.
Cohort study of smear-positive tuberculosis (TB) retreatment cases.
Of 250 cases started on Category II retreatment, 209 were relapse cases; of these, 18 were INH-resistant RMP-susceptible, 18 were INH+RMP-resistant and nine were culture-negative. Of 19 return after interruption cases, two were INH-resistant RMP-susceptible and one was INH+RMP-resistant. Among 22 failures, no case was INH-resistant RMP-susceptible, six were INH+RMP-resistant and 14 were culture-negative. No INH-susceptible RMP-resistant cases were observed. Among 182 INH+RMP-susceptible cases, one failed and four relapsed during follow-up. Two of the five cases became INH+RMP-resistant and the remaining three remained susceptible. Among 20 INH-resistant RMP-susceptible cases, two failed and none relapsed. One of the two became INH+RMP-resistant and the other case remained INH-resistant RMP-susceptible.
The proportion of resistance among retreatment cases in Kathmandu Valley was not high. The risk of relapse with amplification of RMP resistance among INH-resistant RMP-susceptible cases on the Category II retreatment regimen was 5% (1/20), and that among INH+RMP-susceptible cases was 1% (2/182).
尼泊尔加德满都谷市区。
研究 II 类复治方案后异烟肼（INH）和利福平（RMP）耐药性扩增的失败和复发概率。
痰涂片阳性肺结核（TB）复治病例的队列研究。
250 例开始 II 类复治的病例中，209 例为复发病例；其中，18 例为 INH 耐药 RMP 敏感，18 例为 INH+RMP 耐药，9 例为培养阴性。19 例中断后返回的病例中，2 例为 INH 耐药 RMP 敏感，1 例为 INH+RMP 耐药。在 22 例失败病例中，无一例为 INH 耐药 RMP 敏感，6 例为 INH+RMP 耐药，14 例为培养阴性。未观察到 INH 敏感 RMP 耐药病例。在 182 例 INH+RMP 敏感病例中，1 例失败，4 例在随访中复发。5 例中有 2 例发生 INH+RMP 耐药，其余 3 例仍为敏感。在 20 例 INH 耐药 RMP 敏感病例中，2 例失败，无 1 例复发。其中 1 例转为 INH+RMP 耐药，另 1 例仍为 INH 耐药 RMP 敏感。
加德满都谷复治病例的耐药比例不高。在 II 类复治方案中，INH 耐药 RMP 敏感病例中 RMP 耐药扩增的复发风险为 5%（1/20），而 INH+RMP 敏感病例的复发风险为 1%（2/182）。
