Department of Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. aylinbabalik＠gmail.com
Jpn J Infect Dis. 2013;66(2):115-20. doi: 10.7883/yoken.66.115.
The aim of this study is to evaluate the treatment outcomes and identify factors associated with adverse tuberculosis treatment outcomes for bacteriologically confirmed pulmonary tuberculosis. Treatment outcomes of pulmonary tuberculosis were evaluated retrospectively among 11,186 smear- and/or culture-positive patients treated between 2006 and 2009 in Istanbul, Turkey. Adverse treatment outcomes were identified in 1,010 (9.0%) patients including death (1.8%), treatment default (6.1%), and treatment failure (1.1%). Factors associated with adverse treatment outcomes included being born abroad (odds ratios [OR], 5.38; 95% confidence intervals [CI], 3.67-7.91), history of tuberculosis treatment (OR, 3.77; 95% CI, 3.26-4.36), age > 65 years (OR, 2.79; 95% CI, 2.21-3.53), and male gender (OR, 1.91; 95% CI, 1.59-2.27). Death was most strongly associated with age > 65 years (OR, 45.1; 95% CI, 27.0-75.6), followed by treatment default with history of interrupted treatment (OR, 11.6; 95% CI, 8.94-15.1), and treatment failure with prior history of treatment failure (OR, 17.1; 95% CI, 6.97-41.6). Multidrug resistance was strongly associated with adverse treatment outcomes (OR, 10.8; 95% CI, 8.02-14.6). Age > 65 years, male sex, being born abroad, and history of treatment failure were found to be risk factors for adverse treatment outcomes. Hence, patients with any of these characteristics should be carefully monitored and treated aggressively.
本研究旨在评估治疗结果，并确定与细菌学确诊的肺结核治疗结果不良相关的因素。在土耳其伊斯坦布尔，对 2006 年至 2009 年间治疗的 11,186 例涂片和/或培养阳性患者进行了肺结核治疗结果的回顾性评估。1,010 例（9.0%）患者发生不良治疗结局，包括死亡（1.8%）、治疗中断（6.1%）和治疗失败（1.1%）。与不良治疗结局相关的因素包括在国外出生（比值比[OR]，5.38；95%置信区间[CI]，3.67-7.91）、有结核病治疗史（OR，3.77；95% CI，3.26-4.36）、年龄>65 岁（OR，2.79；95% CI，2.21-3.53）和男性（OR，1.91；95% CI，1.59-2.27）。死亡与年龄>65 岁密切相关（OR，45.1；95% CI，27.0-75.6），其次是中断治疗史的治疗中断（OR，11.6；95% CI，8.94-15.1），以及既往治疗失败史的治疗失败（OR，17.1；95% CI，6.97-41.6）。耐多药与不良治疗结局密切相关（OR，10.8；95% CI，8.02-14.6）。年龄>65 岁、男性、在国外出生和治疗失败史被认为是不良治疗结局的危险因素。因此，具有这些特征之一的患者应密切监测并积极治疗。
