Flor de Lima Bárbara, Tavares Margarida
Master Programme in Medicine, Hospital de São João and University of Porto Medical School, Portugal.
Clin Respir J. 2014 Jan;8(1):11-23. doi: 10.1111/crj.12044. Epub 2013 Oct 1.
Extensively drug-resistant tuberculosis (XDR-TB) is emerging as a global public health problem. Its treatment is more expensive and difficult, and the outcomes much severe. The identification of risk factors for XDR-TB is of paramount importance to design effective TB control strategies.
To review published articles on risk factors for XDR-TB.
We identified 249 English articles on PubMed, and 182 were excluded by the abstract. The remaining articles were retrieved for full-text detailed evaluation by authors, and 27 relevant articles were selected for final review.
Some risk factors were consistently present, mainly previous TB treatment and its length. Other conditions often associated were immigration, alcoholism and HIV coinfection. Pre-XDR-TB points to an increased risk of XDR-TB.
The information regarding determinants of XDR-TB is relatively weak. However, special emphasis should be given to minimize the risks of TB retreatment to prevent the emergence of highly resistant TB.
广泛耐药结核病（XDR-TB）正成为一个全球公共卫生问题。其治疗成本更高且难度更大，后果也更为严重。确定XDR-TB的危险因素对于设计有效的结核病控制策略至关重要。
综述已发表的关于XDR-TB危险因素的文章。
我们在PubMed上检索到249篇英文文章，通过摘要排除了182篇。其余文章由作者检索全文进行详细评估，最终选取27篇相关文章进行综述。
一些危险因素始终存在，主要是既往结核病治疗及其疗程。其他常相关的情况有移民、酗酒和HIV合并感染。广泛耐药前结核病提示XDR-TB风险增加。
关于XDR-TB决定因素的信息相对较少。然而，应特别强调尽量降低结核病复治的风险，以预防高度耐药结核病的出现。
