Gaifer Zied, Babiker Ahmed, Rizavi Dawar
Department of Medicine, Sultan Qaboos University Hospital, Al-Khoud, Oman.
Department of Internal Medicine, Providence Hospital, Washington D.C, United States of America.
Oman Med J. 2017 Jan;32(1):36-40. doi: 10.5001/omj.2017.07.
The aim of this study was to estimate the prevalence and identify the risk factors for the development of drug-resistant infection in a tertiary care center in Oman.
We performed a cross-sectional review of culture-confirmed tuberculosis (TB) cases diagnosed at Sultan Qaboos University Hospital between August 2006 and March 2015. We compared drug-resistant TB cases with drug-sensitive cases to identify predictors of drug-resistant TB using univariate and multivariate logistic regression analysis.
Of the 260 TB cases reviewed, 73.1% were confirmed by culture. The proportion of multi-drug resistant TB was 1.8%. TB isolates resistant to any of the first-line TB drugs comprised (7.5%) of cases. Pyrazinamide monoresistance was the most frequently reported drug monoresistant pattern (3.5%). Previous treatment for TB (odds ratio (OR) 14.81; 95% CI 3.09-70.98, < 0.001), female gender (OR 3.85; 95% Cl 1.07-13.90, < 0.039), and younger age (OR 6.80; 95% Cl 1.61-28.75, < 0.009) were found to be risk factors for development of first-line antituberculosis drug-resistant TB in multivariate analysis.
Our results show that the rate of drug-resistant TB in our population is a public health issue of great concern. Previous treatment with antituberculosis drugs, female gender, and younger age are risk factors for the development of drug-resistant TB. These findings are useful adjuvants to guide clinicians and public health professionals in the early detection and appropriate treatment of cases of drug-resistant TB.
本研究旨在评估阿曼一家三级医疗中心耐药感染的患病率,并确定其发生的风险因素。
我们对2006年8月至2015年3月在苏丹卡布斯大学医院确诊的经培养证实的肺结核(TB)病例进行了横断面回顾性研究。我们将耐药结核病病例与药物敏感病例进行比较,采用单因素和多因素逻辑回归分析来确定耐药结核病的预测因素。
在回顾的260例TB病例中,73.1%经培养确诊。耐多药结核病的比例为1.8%。对任何一种一线抗结核药物耐药的结核分枝杆菌分离株占病例的7.5%。吡嗪酰胺单耐药是最常报告的药物单耐药模式(3.5%)。多因素分析发现,既往有结核病治疗史(比值比(OR)14.81;95%可信区间3.09 - 70.98,P < 0.001)、女性(OR 3.85;95%可信区间1.07 - 13.90,P < 0.039)和年龄较小(OR 6.80;95%可信区间1.61 - 28.75,P < 0.009)是一线抗结核药物耐药结核病发生的风险因素。
我们的结果表明,我国人群中的耐药结核病发生率是一个令人高度关注的公共卫生问题。既往使用抗结核药物治疗、女性和年龄较小是耐药结核病发生的风险因素。这些发现有助于指导临床医生和公共卫生专业人员早期发现并适当治疗耐药结核病病例。