Sander M S, Vuchas C Y, Numfor H N, Nsimen A N, Abena J-L F, Noeske J, Van Deun A, Morgan K L
Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon; German International Cooperation, Yaounde, Cameroon.
Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon.
Int J Tuberc Lung Dis. 2016 Jun;20(6):793-9. doi: 10.5588/ijtld.15.0259.
Rapid and effective diagnosis of multidrug-resistant tuberculosis (MDR-TB) is an essential component of global tuberculosis (TB) control, but most MDR-TB cases are still not diagnosed.
To assess whether patient sputum bacterial load can be used to identify patients at increased risk of MDR-TB.
We used a case-control study and multivariable logistic regression models to investigate associations between MDR-TB and sputum bacterial load, as measured by semi-quantitative microscopy and automated time to detection (TTD) of liquid culture. We assessed data from retreatment TB patients with MDR-TB (cases) and from those without MDR-TB (controls) at a reference laboratory in Cameroon.
MDR-TB was associated with a smear microscopy grade of 3+ (OR 21.9, 95%CI 6.2-76.8) or 2+ (OR 10.8, 95%CI 2.9-40.7), compared to a result of 1+, scanty or smear-negative among 80 MDR-TB cases and 521 controls. MDR-TB was associated with automated TTD of ⩿160 h (OR 2.2, 95%CI 1.1-4.7) compared to >160 h among a subpopulation of 47 cases and 350 controls.
A higher sputum bacterial load is associated with MDR-TB in retreatment patients in Cameroon.
快速有效地诊断耐多药结核病（MDR-TB）是全球结核病控制的重要组成部分，但大多数耐多药结核病病例仍未得到诊断。
评估患者痰液细菌载量是否可用于识别耐多药结核病风险增加的患者。
我们采用病例对照研究和多变量逻辑回归模型，研究耐多药结核病与痰液细菌载量之间的关联，痰液细菌载量通过半定量显微镜检查和液体培养的自动检测时间（TTD）来测量。我们评估了喀麦隆一家参考实验室中耐多药结核病复治患者（病例）和非耐多药结核病患者（对照）的数据。
在80例耐多药结核病病例和521例对照中，与涂片镜检结果为1+、少量或涂片阴性相比，耐多药结核病与涂片镜检等级为3+（比值比21.9，95%置信区间6.2-76.8）或2+（比值比10.8，95%置信区间2.9-40.7）相关。在47例病例和350例对照的亚组中，与TTD>160小时相比，耐多药结核病与自动TTD⩿160小时相关（比值比2.2，95%置信区间1.1-4.7）。
喀麦隆复治患者中较高的痰液细菌载量与耐多药结核病相关。
