Brodhun B, Altmann D, Hauer B, Fiebig L, Haas W
Abteilung für Infektionsepidemiologie, Fachgebiet für respiratorisch übertragbare Erkrankungen, Robert Koch-Institut Berlin.
Pneumologie. 2015 May;69(5):263-70. doi: 10.1055/s-0034-1391922. Epub 2015 May 13.
In addition to malaria and HIV/AIDS, tuberculosis (TB) is one of the world's most important infectious diseases. Also in Germany tuberculosis still remains a relevant public health problem that needs special attention.
This article provides an overview of the tuberculosis epidemiology in Germany with emphasis on drug resistance and population groups that are predominantly affected.
Based on surveillance data provided in the notification system, the TB-situation in Germany is presented-particularly with respect to drug resistance, origin of patients (country of birth and nationality) and treatment outcome.
Since 2009, the continuous decline in case numbers has slowed down and is now stagnating as observed in several other industrialized nations. Since 2007, the proportion of foreign-born patients has continuously increased and accounts for over half of all cases registered in Germany. Special attention deserves the current drug resistance situation: With a proportion of 3.4% in 2013, multidrug-resistant tuberculosis (MDR-TB) has increased significantly compared to the previous year (2.1%) and the rate is therefore higher than in many other European low-incidence countries. Particularly high levels of MDR-TB were observed among foreign-born patients originating from a former Soviet Union country. On average, treatment success was observed in 79% of the cases. Thus, Germany does not reach the WHO target of 85% treatment success. Stagnating case numbers together with the observed drug resistance trend clearly indicate the need for continued efforts in tuberculosis control in Germany including focused strategies for the most affected population groups.
除疟疾和艾滋病毒/艾滋病外，结核病是世界上最重要的传染病之一。在德国，结核病仍然是一个需要特别关注的重要公共卫生问题。
本文概述了德国的结核病流行病学情况，重点关注耐药性以及主要受影响的人群。
基于通报系统提供的监测数据，介绍德国的结核病情况，特别是在耐药性、患者来源（出生国家和国籍）以及治疗结果方面。
自2009年以来，病例数持续下降的趋势有所放缓，目前处于停滞状态，其他几个工业化国家也有类似情况。自2007年以来，外国出生患者的比例持续上升，占德国登记的所有病例的一半以上。当前的耐药情况值得特别关注：2013年耐多药结核病（MDR-TB）的比例为3.4%，与上一年（2.1%）相比显著增加，因此该比例高于许多其他欧洲低发病率国家。在前苏联国家出生的外国患者中观察到特别高的耐多药结核病水平。平均而言，79%的病例治疗成功。因此，德国未达到世界卫生组织85%的治疗成功率目标。病例数停滞不前以及观察到的耐药趋势清楚地表明，德国需要继续努力控制结核病，包括针对受影响最严重人群的重点策略。
