Cakir Erkan, Erdem Ela, Ozlu Nagihan, Seber Engin, Gencer Serap, Kilicaslan Zeki
Bezmialem Vakif University, Istanbul, Turkey.
J Infect Dev Ctries. 2014 Mar 13;8(3):304-9. doi: 10.3855/jidc.3950.
Although tuberculosis (TB) is frequently seen in Turkey, there are limited studies on childhood TB. We aimed to describe clinical and laboratory findings, including drug resistance, of children with TB in Istanbul, Turkey.
The study included all children aged 0-14 years who were registered in public dispensaries between 2006 and 2010.
The study included 1,541 cases. Forty-four percent (n = 763) of the patients were male with a mean age of 8.86 ± 4.19 years. Fifty-five percent of the patients had pulmonary TB, 39% had extrapulmonary TB, and 6% had both pulmonary and extrapulmonary TB. The most common extrapulmonary involvement sites were the pleura (n = 193), lymph nodes (n = 247), and central nervous system (n = 41). Forty-one percent of the patients were evaluated microbiologically and 35% of them were positive. For the total study group, 14% of them were positive. A drug susceptibility test was performed on 108 patients. Drug resistance to at least one drug was detected in 16% (n = 17), to isoniazid in 15% (n = 16), streptomycin in 12% (n = 12), rifampicin in 9% (n = 10), ethambutol in 7% (n = 8), and multi-drug resistance in 8% (n = 9) of patients.
This is the largest analysis on demographic features and drug resistance of childhood TB in Turkey. In Turkey, the rate of microbiological diagnosis is low, similar to rates worldwide. More microbiological studies and drug resistance tests should be done and annual changes should be followed with multi-center studies.
尽管土耳其结核病（TB）病例常见，但关于儿童结核病的研究有限。我们旨在描述土耳其伊斯坦布尔儿童结核病的临床和实验室检查结果，包括耐药情况。
该研究纳入了2006年至2010年间在公共药房登记的所有0至14岁儿童。
该研究共纳入1541例病例。44%（n = 763）的患者为男性，平均年龄为8.86 ± 4.19岁。55%的患者患有肺结核，39%患有肺外结核，6%同时患有肺结核和肺外结核。最常见的肺外受累部位是胸膜（n = 193）、淋巴结（n = 247）和中枢神经系统（n = 41）。41%的患者进行了微生物学评估，其中35%呈阳性。在整个研究组中，14%呈阳性。对108例患者进行了药敏试验。16%（n = 17）的患者检测出对至少一种药物耐药，15%（n = 16）对异烟肼耐药，12%（n = 12）对链霉素耐药，9%（n = 10）对利福平耐药，7%（n = 8）对乙胺丁醇耐药，8%（n = 9）的患者对多种药物耐药。
这是对土耳其儿童结核病人口统计学特征和耐药性的最大规模分析。在土耳其，微生物学诊断率较低，与全球水平相似。应开展更多的微生物学研究和药敏试验，并通过多中心研究跟踪年度变化情况。
