Scheelbeek Pauline F D, Wirix Aleid J G, Hatta Mohammad, Usman Romi, Bakker Mirjam I
Southeast Asian J Trop Med Public Health. 2014 Jul;45(4):853-8.
Resistant tuberculosis is an important public health problem in South Sulawesi, Indonesia. We conducted a retrospective cohort study of 1,582 smear positive tuberculosis patients registered with the National Tuberculosis Program during 2007 in Makassar, Indonesia, to assess risk factors associated with poor tuberculosis treatment outcomes. Of the 1,582 patients, 265 had a poor treatment outcome. Of the 265 patients with a poor treatment outcome, 216 had defaulted on treatment, 7 failed treatment, 9 died and 33 transferred to another area. After adjusting for sex, age and BCG status, failure acid-fast bacilli (AFB) positive sputum to convert to AFB negative by 2-3 months was the only risk factor significantly associated with a poor treatment outcome (odds ratio 7.57; 95% CI: 1.22-47.1). We hypothesise this could represent resistant tuberculosis. Early identification of resistant tuberculosis is important and should be suspected in patients whose AFB positive sputum samples fail to convert to AFB negative by 2-3 months.
耐多药结核病是印度尼西亚南苏拉威西省的一个重要公共卫生问题。我们对2007年在印度尼西亚望加锡国家结核病项目登记的1582例涂片阳性肺结核患者进行了一项回顾性队列研究，以评估与结核病治疗效果不佳相关的危险因素。在这1582例患者中，265例治疗效果不佳。在这265例治疗效果不佳的患者中，216例中断治疗，7例治疗失败，9例死亡，33例转至其他地区。在对性别、年龄和卡介苗接种状况进行校正后，2 - 3个月时痰涂片抗酸杆菌（AFB）阳性仍未转为阴性是与治疗效果不佳显著相关的唯一危险因素（比值比7.57；95%置信区间：1.22 - 47.1）。我们推测这可能代表耐多药结核病。耐多药结核病的早期识别很重要，对于痰涂片AFB阳性样本在2 - 3个月内未转为阴性的患者应怀疑患有耐多药结核病。
