Scalcini M, Carré G, Jean-Baptiste M, Hershfield E, Parker S, Wolfe J, Nelz K, Long R
Department of Medicine, Hôpital Albert Schweitzer, Deschapelles, Haiti.
Am Rev Respir Dis. 1990 Sep;142(3):508-11. doi: 10.1164/ajrccm/142.3.508.
To determine the prevalence of antituberculous drug resistance in Haiti, we conducted a 1-yr survey in a central district. From a bacillary positive (smear and/or culture positive) case rate of 80/100,000, there were 282 patients from whom Mycobacterium tuberculosis was cultured. Each isolate was packaged and delivered to Canada where speciation and drug susceptibility testing were performed. Reported resistances are those using the proportions method (Laboratory Center for Disease Control, Ottawa, Canada). Resistance to one or more drugs was found in 22% of isolates. Age was the most important predictor of resistance in Haiti; resistance rates for age groups less than 14, 14 to 29, 30 to 44, greater than or equal to 45 were 8, 19, 22, and 31%, respectively. In patients not known to have received antituberculous drugs in the past, resistances were isoniazid (19%), streptomycin (5%), ethambutol (2%), ethionamide (2%), rifampin (1%). We conclude that antituberculous drug resistance is prevalent in Haiti, especially in older age groups, and that in persons with no known antituberculous drug use in the past, resistance to isoniazid is significant.
为确定海地抗结核药物耐药性的流行情况，我们在一个中心地区开展了为期1年的调查。根据每10万人中80例菌阳（涂片和/或培养阳性）的病例率，共培养出282例结核分枝杆菌患者。每个菌株被包装后送往加拿大，在那里进行菌种鉴定和药敏试验。报告的耐药率采用比例法（加拿大渥太华疾病控制实验室中心）。在22%的菌株中发现对一种或多种药物耐药。年龄是海地耐药性最重要的预测因素；年龄小于14岁、14至29岁、30至44岁、大于或等于45岁组的耐药率分别为8%、19%、22%和31%。在过去未知是否接受过抗结核药物治疗的患者中，异烟肼耐药率为19%，链霉素为5%，乙胺丁醇为2%，乙硫异烟胺为2%，利福平为1%。我们得出结论，抗结核药物耐药性在海地普遍存在，尤其是在老年人群体中，而且在过去未知使用过抗结核药物的人群中，异烟肼耐药情况较为显著。
