Gupta Anamika, Mathuria Jitendra Prasad, Singh Surya Kumar, Gulati Anil Kumar, Anupurba Shampa
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
J Health Popul Nutr. 2011 Dec;29(6):583-92.
Tuberculosis (TB) is a major public-health problem in India, having the highest number of incident and multidrug-resistant (MDR) TB cases. The study was carried out to appraise the prevalence of first-line anti-TB drug resistance in Mycobacterium tuberculosis (MTB) and its patterns among different types of TB patients from different settings in a province of North India. Of 3,704 clinical specimens, 345 (9.3%) were culture-positive, and drug-susceptibility testing was carried out for 301 MTB strains. A high level of primary and acquired drug resistance of MTB was observed in the region studied, with weighted mean of 10.5% and 28.08%, 12.81% and 29.72%, 17.12% and 29.94%, 11.97% and 27.84%, and 10.74% and 23.54% for rifampicin, isoniazid, streptomycin, ethambutol-resistant and MDR cases respectively. Drug resistance was significantly higher in pulmonary (p = 0.014) and acquired drug-resistant TB cases (p < 0.001). Any drug resistance (p = 0.002) and MDR TB were significantly (p = 0.009) associated with HIV-seropositive cases. An urgent plan is needed to continuously monitor the transmission trends of drug-resistant strains, especially MDR-TB strains, in the region.
结核病是印度的一个主要公共卫生问题，其新发和耐多药结核病病例数量位居全球之首。本研究旨在评估印度北部某省不同类型结核病患者中结核分枝杆菌（MTB）对一线抗结核药物的耐药率及其模式。在3704份临床标本中，345份（9.3%）培养呈阳性，对301株MTB菌株进行了药敏试验。在所研究的地区观察到MTB的原发性和获得性耐药水平较高，利福平、异烟肼、链霉素、乙胺丁醇耐药及耐多药病例的加权平均值分别为10.5%和28.08%、12.81%和29.72%、17.12%和29.94%、11.97%和27.84%、10.74%和23.54%。肺部结核病（p = 0.014）和获得性耐药结核病病例（p < 0.001）的耐药率显著更高。任何耐药（p = 0.002）和耐多药结核病与HIV血清阳性病例显著相关（p = 0.009）。需要制定紧急计划，持续监测该地区耐药菌株，尤其是耐多药结核菌株的传播趋势。
