沙特阿拉伯麦地那市新发病例中耐多药结核分枝杆菌的负担
Burden of Multidrug Resistant Mycobacterium tuberculosis Among New Cases in Al-Madinah Al-Monawarah, Saudi Arabia.
作者信息
Elhassan Mogahid M, Hemeg Hassan A, Elmekki Miskelyemen A, Turkistani Khalid A, Abdul-Aziz Ahmed A
机构信息
Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Monawrah. Saudi Arabia.
Department of Medical Laboratory Technology, College of Applied Medical Sciences, Taibah University, Al Madenah Al Monawarah. Saudi Arabia.
出版信息
Infect Disord Drug Targets. 2017;17(1):14-23. doi: 10.2174/1871526517666161116104242.
BACKGROUND
The pattern of Mycobacterium tuberculosis susceptibility to first line drugs and multidrug resistance in Al-Madinah Al-Munawarah, a seasonally overcrowded are during Hajj and Omrah, is not well studied.
OBJECTIVE
This study aimed to investigate anti-tuberculosis drug resistance and its distribution among new cases in Al-Madinah Al-Monawarah.
METHODS
Study subjects included 622 patients with first time confirmed TB referred to the central tuberculosis laboratory in Al-Madinah between January 2012 and December 2014.
RESULTS
Out of the 622 isolates, 99 (15.9%) were Mycobacteria Other Than Tuberculosis (MOTTS) and 25 (4.0%), three of which (12%) were children under five years of age, revealed multidrug resistance (MDR). Monoresistance to isoniazid (H) was (1.8%), to rifampin (R) was (1.4%), to streptomycin (S) was (1.9 %) to ethambutol (E) was (1.1 %) and to pyrazinamide (Z) was (2.1%).
CONCLUSION
Being among the new cases, multidrug resistant tuberculosis (MDR TB) is supposed to be caused by strains which are originally multidrug resistant. Neither nationality nor gender was found to be associated with MDR TB. Since 12% of MDR cases were among children, a probability of primary infection with MDR strains is to be considered. Moreover, mass gathering during Hajj and Omrah seasons does not seem to increase the burden of MDR in the region. However, further investigation is needed to molecularly characterize MDR isolates and their phylogenetics and geographical origin.
背景
在朝觐和副朝期间季节性人满为患的麦地那，结核分枝杆菌对一线药物的敏感性模式和耐多药情况尚未得到充分研究。
目的
本研究旨在调查麦地那新确诊病例中的耐多药结核病情况及其分布。
方法
研究对象包括2012年1月至2014年12月期间转诊至麦地那中央结核病实验室的622例首次确诊结核病患者。
结果
在622株分离菌株中，99株（15.9%）为非结核分枝杆菌（MOTTS），25株（4.0%）显示耐多药（MDR），其中3例（12%）为5岁以下儿童。对异烟肼（H）的单耐药率为（1.8%），对利福平（R）为（1.4%），对链霉素（S）为（1.9%），对乙胺丁醇（E）为（1.1%），对吡嗪酰胺（Z）为（2.1%）。
结论
在新确诊病例中，耐多药结核病（MDR-TB）被认为是由原本耐多药的菌株引起的。未发现国籍和性别与耐多药结核病有关。由于12%的耐多药病例为儿童，因此应考虑原发性耐多药菌株感染的可能性。此外，朝觐和副朝季节的大规模聚集似乎并未增加该地区耐多药结核病的负担。然而，需要进一步调查以对耐多药分离株及其系统发育和地理起源进行分子特征分析。
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