喀麦隆中部地区国家结核病控制规划重组12年后，链霉素耐药性大幅下降且未出现广泛耐药情况。

Strong decrease in streptomycin-resistance and absence of XDR 12 years after the Reorganization of the National Tuberculosis Control Program in the Central Region of Cameroon.

作者信息

Sidze Larissa Kamgue, Mouafo Tekwu Emmanuel, Kuaban Christopher, Assam Assam Jean-Paul, Tedom Jean-Claude, Eyangoh Sara, Fouda François-Xavier, Nolna Désiré, Ntoumi Francine, Frank Matthias, Penlap Beng Véronique N

机构信息

Laboratory for Tuberculosis Research (LTR), Biotechnology Center (BTC), University of Yaoundé I, Yaoundé, Cameroon; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Central African Network for Tuberculosis, AIDS/HIV and Malaria (CANTAM), Brazzaville, Congo.

Pneumology Unit, Jamot Hospital, Yaoundé, Cameroon.

出版信息

PLoS One. 2014 Jun 5;9(6):e98374. doi: 10.1371/journal.pone.0098374. eCollection 2014.

DOI:10.1371/journal.pone.0098374

PMID:24901982

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4047025/

Abstract

BACKGROUND

In the 1990s, resistance rates of 15% for streptomycin-resistance and 0.6% for multidrug-resistance (MDR) were reported from the Central Region of Cameroon. This work assesses drug resistant tuberculosis in this region 12 years after reorganization of the National Tuberculosis Control Program (NTCP).

METHODS

This cross-sectional study was conducted from April 2010 to March 2011 in Jamot Hospital in Yaoundé, Cameroon. Only patients with smear positive pulmonary tuberculosis were included. Sputa were cultured and subsequently underwent drug susceptibility testing (DST). All consenting individuals were tested for their HIV status.

RESULTS

A total of 665 smear positive pulmonary tuberculosis patients were enrolled. The HIV prevalence was 28.5% (95%CI [25.2-32.1]). Of the 582 sputa that grew Mycobacterium tuberculosis complex species, DST results were obtained for 576. The overall resistance rate was 10.9% (63/576). The overall resistance rates for single drug resistance were: isoniazid-resistance 4.7% (27/576), streptomycin-resistance 3.3% (19/576), rifampicin-resistance 0.2% (1/576), kanamycin-resistance 0.2% (1/576) and ofloxacin-resistance 0.2% (1/576). The MDR rate was 1.1% (6/576) and no extensively drug resistant tuberculosis (XDR) was detected.

CONCLUSIONS

The data show that reorganization of the NTCP resulted in a strong decrease in streptomycin-resistance and suggest that it prevented the emergence of XDR in the Central Region of Cameroon.

摘要

背景

20世纪90年代，喀麦隆中部地区报告的链霉素耐药率为15%，多重耐药（MDR）率为0.6%。这项研究评估了国家结核病控制规划（NTCP）重组12年后该地区的耐药结核病情况。

方法

这项横断面研究于2010年4月至2011年3月在喀麦隆雅温得的贾莫特医院进行。仅纳入痰涂片阳性的肺结核患者。痰液进行培养，随后进行药敏试验（DST）。所有同意的个体均检测其HIV状态。

结果

共纳入665例痰涂片阳性的肺结核患者。HIV感染率为28.5%（95%CI[25.2 - 32.1]）。在582份培养出结核分枝杆菌复合群菌种的痰液中，576份获得了DST结果。总体耐药率为10.9%（63/576）。单药耐药的总体耐药率分别为：异烟肼耐药4.7%（27/576），链霉素耐药3.3%（19/576），利福平耐药0.2%（1/576），卡那霉素耐药0.2%（1/576），氧氟沙星耐药0.2%（1/576）。MDR率为1.1%（6/576），未检测到广泛耐药结核病（XDR）。