Günther Gunar, van Leth Frank, Alexandru Sofia, Altet Neus, Avsar Korkut, Bang Didi, Barbuta Raisa, Bothamley Graham, Ciobanu Ana, Crudu Valeriu, Davilovits Manfred, Dedicoat Martin, Duarte Raquel, Gualano Gina, Kunst Heinke, de Lange Wiel, Leimane Vaira, Magis-Escurra Cecile, McLaughlin Anne-Marie, Muylle Inge, Polcová Veronika, Pontali Emanuele, Popa Christina, Rumetshofer Rudolf, Skrahina Alena, Solodovnikova Varvara, Spinu Victor, Tiberi Simon, Viiklepp Piret, Lange Christoph
Emerg Infect Dis. 2015 Mar;21(3):409-16. doi: 10.3201/eid2103.141343.
Drug-resistant Mycobacterium tuberculosis is challenging elimination of tuberculosis (TB). We evaluated risk factors for TB and levels of second-line drug resistance in M. tuberculosis in patients in Europe with multidrug-resistant (MDR) TB. A total of 380 patients with MDR TB and 376 patients with non-MDR TB were enrolled at 23 centers in 16 countries in Europe during 2010-2011. A total of 52.4% of MDR TB patients had never been treated for TB, which suggests primary transmission of MDR M. tuberculosis. At initiation of treatment for MDR TB, 59.7% of M. tuberculosis strains tested were resistant to pyrazinamide, 51.1% were resistant to ≥1 second-line drug, 26.6% were resistant to second-line injectable drugs, 17.6% were resistant to fluoroquinolones, and 6.8% were extensively drug resistant. Previous treatment for TB was the strongest risk factor for MDR TB. High levels of primary transmission and advanced resistance to second-line drugs characterize MDR TB cases in Europe.
耐多药结核分枝杆菌对结核病的消除构成挑战。我们评估了欧洲耐多药结核病患者中结核病的危险因素以及结核分枝杆菌对二线药物的耐药水平。2010年至2011年期间，在欧洲16个国家的23个中心共纳入了380例耐多药结核病患者和376例非耐多药结核病患者。52.4%的耐多药结核病患者从未接受过结核病治疗，这表明耐多药结核分枝杆菌存在原发性传播。在开始耐多药结核病治疗时，59.7%的结核分枝杆菌菌株对吡嗪酰胺耐药，51.1%对≥1种二线药物耐药，26.6%对二线注射用药物耐药，17.6%对氟喹诺酮类耐药，6.8%为广泛耐药。既往结核病治疗是耐多药结核病最强的危险因素。原发性传播水平高和对二线药物的耐药性进展是欧洲耐多药结核病病例的特征。
