James Prince, Gupta Richa, Christopher Devasahayam Jesudas, Thankagunam Balamugesh, Veeraraghavan Balaji
Department of Pulmonary Medicine, Christian Medical College, Vellore, India.
Clin Respir J. 2011 Jan;5(1):19-25. doi: 10.1111/j.1752-699X.2009.00184.x.
To study the anti-tubercular drug resistance pattern among suspected cases of drug-resistant TB.
First and second line drug susceptibility data were retrospectively analysed for all suspected cases of drug-resistant tuberculosis (TB), presenting to the Pulmonary Medicine department of tertiary care hospital in South India from 2003 to 2007.
Out of 177 cases of suspected drug-resistant TB, 103 (58.2%) cases were multi-drug-resistant tuberculosis (MDR-TB). Out of 75 cases of MDR-TB for whom second-line drug susceptibility test was performed, 45 (60.0%) cases met the criteria of extensively drug-resistant (XDR) TB, which is very high when compared with existing worldwide data on XDR-TB (6.6% cases of MDR-TB). In comparison with non-MDR-TB cases, MDR and XDR-TB cases had a history of significantly higher duration of anti-TB treatment (ATT) and significantly higher exposure to multiple ATT regimens. Past exposure to second-line anti-TB drugs was significantly high in XDR-TB cases than in MDR-TB and non MDR-TB cases.
This study highlights the high burden of XDR- and MDR-TB among TB patients coming to tertiary care hospitals in India.
研究耐多药结核病疑似病例的抗结核药物耐药模式。
对2003年至2007年期间到印度南部一家三级医院肺病科就诊的所有耐多药结核病疑似病例的一线和二线药物敏感性数据进行回顾性分析。
在177例耐多药结核病疑似病例中，103例（58.2%）为耐多药结核病（MDR-TB）。在75例进行了二线药物敏感性试验的MDR-TB病例中，45例（60.0%）符合广泛耐药（XDR）结核病标准，与全球现有的XDR-TB数据（MDR-TB病例的6.6%）相比，这一比例非常高。与非MDR-TB病例相比，MDR和XDR-TB病例的抗结核治疗（ATT）持续时间显著更长，且接触多种ATT方案的情况显著更多。XDR-TB病例过去接触二线抗结核药物的情况显著高于MDR-TB和非MDR-TB病例。
本研究突出了印度三级医院结核病患者中XDR-TB和MDR-TB的高负担。
