Lam Eugene, Nateniyom Sriprapa, Whitehead Sara, Anuwatnonthakate Amornrat, Monkongdee Patama, Kanphukiew Apiratee, Inyaphong Jiraphan, Sitti Wanlaya, Chiengsorn Navarat, Moolphate Saiyud, Kavinum Suporn, Suriyon Narin, Limsomboon Pranom, Danyutapolchai Junya, Sinthuwattanawibool Chalinthorn, Podewils Laura Jean
Emerg Infect Dis. 2014 Mar;20(3):400-8. doi: 10.3201/eid2003.130951.
In 2004, routine use of culture and drug-susceptibility testing (DST) was implemented for persons in 5 Thailand provinces with a diagnosis of tuberculosis (TB). To determine if DST results were being used to guide treatment, we conducted a retrospective chart review for patients with rifampin-resistant or multidrug-resistant (MDR) TB during 2004-2008. A total of 208 patients were identified. Median time from clinical sample collection to physician review of DST results was 114 days. Only 5.8% of patients with MDR TB were empirically prescribed an appropriate regimen; an additional 31.3% received an appropriate regimen after DST results were reviewed. Most patients with rifampin -resistant or MDR TB had successful treatment outcomes. Patients with HIV co-infection and patients who were unmarried or had received category II treatment before DST results were reviewed had less successful outcomes. Overall, review of available DST results was delayed, and results were rarely used to improve treatment.
2004年，泰国5个省份对诊断为结核病（TB）的患者实施了常规培养和药敏试验（DST）。为确定药敏试验结果是否被用于指导治疗，我们对2004 - 2008年期间耐利福平或耐多药（MDR）结核病患者进行了回顾性病历审查。共识别出208例患者。从临床样本采集到医生查看药敏试验结果的中位时间为114天。耐多药结核病患者中只有5.8%根据经验使用了合适的治疗方案；在查看药敏试验结果后，另有31.3%的患者接受了合适的治疗方案。大多数耐利福平或耐多药结核病患者治疗成功。合并感染艾滋病毒的患者以及在查看药敏试验结果之前未婚或接受过II类治疗的患者治疗成功率较低。总体而言，可用药敏试验结果的审查延迟，且结果很少用于改善治疗。
