Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Glob Antimicrob Resist. 2016 Mar;4:1-4. doi: 10.1016/j.jgar.2015.11.006. Epub 2015 Dec 13.
The objectives of this study were to determine the impact of diabetes mellitus (DM) on antituberculosis drug resistance in new cases of tuberculosis (TB). A case-control study was conducted on all newly diagnosed pulmonary TB adult patients with DM as cases and without DM as controls who were hospitalised from May 2013 to October 2013 in Iran. A molecular resistance test for rapid detection of resistance to isoniazid and rifampicin was done. Multivariate analysis was performed to determine the impact of DM on any anti-TB drug resistance. In total, 62 TB cases with DM and 64 TB cases without DM were included. TB cases with DM were more likely to be older (59 years vs. 43 years; P=0.001). Two TB-DM patients had multidrug-resistant TB (MDR-TB) (3.2%) compared with no cases of MDR-TB in the control group, and more TB-DM cases had isolates that were resistant to at least one drug (12.9% vs. 10.9%). DM [odds ratio (OR)=4.82, 95% confidence interval (CI) 1-23.57], age <40 years (OR=5.48, 95% CI 1.19-25.29) and history of TB contact (OR=5.86, 95% CI 1.69-20.36) remained significantly associated with any drug resistance in the multivariate analysis. In conclusion, new TB patients with DM are at increased risk of anti-TB drug resistance. More studies are needed to confirm these results.
本研究旨在确定糖尿病（DM）对新发肺结核（TB）患者抗结核药物耐药性的影响。采用病例对照研究方法，选取 2013 年 5 月至 10 月在伊朗住院的所有新发成人肺结核合并 DM 的患者为病例组，以无 DM 的肺结核患者为对照组。对所有患者均进行了异烟肼和利福平耐药的快速分子耐药检测。采用多变量分析确定 DM 对任何抗结核药物耐药性的影响。共纳入 62 例合并 DM 的肺结核病例和 64 例无 DM 的肺结核病例。合并 DM 的肺结核病例年龄较大（59 岁比 43 岁；P=0.001）。与对照组中无耐多药肺结核（MDR-TB）患者相比，有 2 例合并 DM 的肺结核患者（3.2%）患有 MDR-TB，并且有更多的合并 DM 的肺结核病例的分离株至少对一种药物具有耐药性（12.9%比 10.9%）。多变量分析显示，DM（比值比[OR]=4.82，95%置信区间[CI]1-23.57）、年龄<40 岁（OR=5.48，95%CI 1.19-25.29）和结核病接触史（OR=5.86，95%CI 1.69-20.36）与任何药物耐药性仍显著相关。总之，新发肺结核合并 DM 的患者发生抗结核药物耐药的风险增加。需要进一步开展研究来证实这些结果。
