National Center for Communicable Diseases, Ulaanbaatar, Mongolia.
Int J Tuberc Lung Dis. 2011 Sep;15(9):1201-5, i. doi: 10.5588/ijtld.10.0594.
Drug-resistant tuberculosis (TB) has emerged as an obstacle to effective TB control.
The eight district and 21 province TB dispensaries and the two TB hospitals comprising the diagnostic centers for TB in Mongolia.
To investigate drug resistance levels among new and retreated TB cases. Specifically, we determined the prevalence of resistance to rifampin, streptomycin, isoniazid and ethambutol among TB patients with and without prior anti-tuberculosis treatment.
A total of 850 patients (74.1% of eligible and 78.0% of patients with a specimen) had Mycobacterium tuberculosis isolated and are the subject of this analysis. Of these, 200 had a history of prior treatment and 650 did not. Any multidrug resistance was found in 7.5% (95%CI 5.9-9.5), with respectively 27.5% (95%CI 21.8-34.1) and 1.4% (95%CI 0.7-1.6) of patients with and without prior history of treatment.
The most conspicuous finding in our survey was the relatively low prevalence of multidrug resistance among patients without a history of prior treatment, as compared to very high prevalence among previously treated patients. This suggests that retreatment is deficient and poses a threat to continued transmission, which has not yet manifested itself among new patients.
耐药结核病（TB）的出现已成为有效结核病控制的障碍。
蒙古的 8 个区和 21 个省结核病诊所和 2 家结核病医院，构成了结核病诊断中心。
调查新发病例和复发病例的耐药水平。具体来说，我们确定了有和没有既往抗结核治疗的结核病患者对利福平、链霉素、异烟肼和乙胺丁醇的耐药率。
共有 850 名患者（符合条件的患者的 74.1%和有标本的患者的 78.0%）分离出结核分枝杆菌，是本分析的对象。其中，200 名有既往治疗史，650 名没有。发现任何多药耐药率为 7.5%（95%CI 5.9-9.5），分别有 27.5%（95%CI 21.8-34.1）和 1.4%（95%CI 0.7-1.6）的有和没有既往治疗史的患者。
我们调查中最明显的发现是，无既往治疗史患者的多药耐药率相对较低，而既往治疗患者的耐药率非常高。这表明复治不足，对持续传播构成威胁，而新发病例尚未表现出来。
