Desmond Tutu TB Centre, Faculty of Health Sciences, Stellenbosch University, South Africa.
J Infect. 2013 Apr;66(4):320-9. doi: 10.1016/j.jinf.2012.09.002. Epub 2012 Sep 6.
The aminoglycosides and polypeptides are vital drugs for the management of multidrug-resistant (MDR) tuberculosis (TB). Both classes of drug cause hearing loss. We aimed to determine the extent of hearing loss in children treated for MDR-TB.
In this retrospective study, children (<15 years) admitted to Brooklyn Chest Hospital, Cape Town, South Africa, from January 2009 until December 2010, were included if treated for MDR-TB with injectable drugs. Hearing was assessed and classified using audiometry and otoacoustic emissions.
Ninety-four children were included (median age: 43 months). Of 93 tested, 28 (30%) were HIV-infected. Twenty-three (24%) children had hearing loss. Culture-confirmed, as opposed to presumed, diagnosis of TB was a risk factor for hearing loss (OR: 4.12; 95% CI: 1.13-15.0; p = 0.02). Seven of 11 (64%) children classified as having hearing loss using audiometry had progression of hearing loss after finishing the injectable drug.
Hearing loss is common in children treated for MDR-TB. Alternative drugs are required for the treatment of paediatric MDR-TB.
氨基糖苷类和多肽类药物对于耐多药结核病（TB）的治疗至关重要。这两类药物均会导致听力损失。本研究旨在确定接受多药耐药结核治疗的儿童听力损失的程度。
在这项回顾性研究中，纳入了 2009 年 1 月至 2010 年 12 月期间在南非开普敦布鲁克林胸部医院接受注射用药物治疗的耐多药结核患儿。通过听力测试和耳声发射来评估和分类听力。
共纳入了 94 名儿童（中位数年龄：43 个月）。在 93 名接受测试的儿童中，28 名（30%）感染了 HIV。23 名（24%）儿童出现听力损失。与推测性诊断相比，培养证实的结核病诊断是听力损失的危险因素（OR：4.12；95%CI：1.13-15.0；p=0.02）。使用听力测试分类为听力损失的 11 名儿童中有 7 名在完成注射用药物治疗后听力损失加重。
接受多药耐药结核治疗的儿童听力损失较为常见。需要为儿童耐多药结核治疗寻找替代药物。
