Tropical Disease Foundation, Makati Medical Center, Makati, Philippines.
Int J Tuberc Lung Dis. 2011 May;15(5):652-6. doi: 10.5588/ijtld.10.0400.
Prior treatment has been associated with multidrug-resistant tuberculosis (MDR-TB) in many settings. The Philippines ranks fifth among 27 priority countries for MDR-TB.
To determine the rate of MDR-TB among previously treated patients referred for MDR screening and management.
Descriptive study of the rate of MDR-TB among 4705 previously treated patients screened from 2003 to 2008.
MDR-TB was present in 76% of 2438 screened patients who had positive cultures. The proportion of patients with MDR-TB was the same among patients referred from public or DOTS facilities and private or non-DOTS facilities. MDR-TB occurred most frequently among patients who failed treatment with the Category 2 regimen (97%), those who did not demonstrate culture conversion after 3 months of Category 2 treatment (91%), and Category 1 failures (83%). MDR-TB rates were respectively 78% and 57% for Category 2 relapse and return after default (RAD), and respectively 33% and 22% for Category 1 relapse and RAD.
MDR-TB is frequent among previously treated patients in the Philippines. Screening with culture and drug susceptibility testing should be considered for these patients.
在许多情况下，先前的治疗与耐多药结核病（MDR-TB）有关。菲律宾在 27 个耐多药结核病重点国家中排名第五。
确定先前接受过治疗的患者中 MDR-TB 的发生率，这些患者被转诊进行 MDR 筛查和管理。
对 2003 年至 2008 年间筛查的 4705 例先前接受过治疗的患者中 MDR-TB 的发生率进行描述性研究。
在 2438 例阳性培养的筛查患者中，MDR-TB 的比例为 76%。来自公共或 DOTS 设施和私人或非 DOTS 设施转诊的患者中 MDR-TB 的比例相同。在因使用 2 类方案治疗失败（97%）、在接受 2 类方案治疗 3 个月后未显示培养转换（91%）以及 1 类失败（83%）的患者中，MDR-TB 的发生率最高。对于 2 类复发和失访后返治（RAD）患者，MDR-TB 的发生率分别为 78%和 57%，对于 1 类复发和 RAD 患者，MDR-TB 的发生率分别为 33%和 22%。
在菲律宾，先前接受过治疗的患者中 MDR-TB 很常见。对于这些患者，应考虑进行培养和药敏试验筛查。
