Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Med Res. 2011 Mar;133(3):308-11.
BACKGROUND & OBJECTIVES: The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naοve patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB.
This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin.
A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 ± 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent.
INTERPRETATION & CONCLUSIONS: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases.
全球范围内耐多药结核病（MDR-TB）的患病率正在上升。尽管既往的结核病治疗是发生 MDR-TB 的最重要危险因素，但由于自发突变或耐药菌株的传播，初治患者也存在风险。我们旨在确定新诊断的痰阳性肺结核患者中 MDR-TB 的患病率。
这是一项前瞻性、观察性研究，涉及 2008 年至 2009 年在印度新德里新诊断的痰阳性肺结核病例。所有痰阳性肺结核病例均进行分枝杆菌培养和一线药物敏感性检测（DST）。耐多药结核病定义为由至少对异烟肼和利福平耐药的杆菌引起的结核病。
2008 年至 2009 年共纳入 218 例痰阳性肺结核病例。其中，41 例分枝杆菌培养阴性，177 例进行了 DST。患者的平均年龄为 27.8 ± 10.2 岁；59 例（27%）为女性。所有患者均未感染 HIV。在 177 例病例中，发现 2 例 MDR-TB。因此，新诊断肺结核患者中 MDR-TB 的患病率为 1.1%。
在德里的初级保健水平治疗的新诊断痰阳性肺结核患者中，MDR-TB 的患病率较低。缺乏全国和邦范围内 MDR-TB 患病率的代表性数据。应努力继续对新诊断的结核病病例进行 MDR-TB 监测。
