Scott Colleen, Cavanaugh Joseph S, Silk Benjamin J, Ershova Julia, Mazurek Gerald H, LoBue Philip A, Moonan Patrick K
Emerg Infect Dis. 2017 Mar;23(3):456-462. doi: 10.3201/eid2303.161916.
Current US guidelines recommend longer treatment for tuberculosis (TB) caused by pyrazinamide-resistant organisms (e.g., Mycobacterium bovis) than for M. tuberculosis TB. We compared treatment response times for patients with M. bovis TB and M. tuberculosis TB reported in the United States during 2006-2013. We included culture-positive, pulmonary TB patients with genotyping results who received standard 4-drug treatment at the time of diagnosis. Time to sputum-culture conversion was defined as time between treatment start date and date of first consistently culture-negative sputum. We analyzed 297 case-patients with M. bovis TB and 30,848 case-patients with M. tuberculosis TB. After 2 months of treatment, 71% of M. bovis and 65% of M. tuberculosis TB patients showed conversion of sputum cultures to negative. Likelihood of culture conversion was higher for M. bovis than for M. tuberculosis, even after controlling for treatment administration type, sex, and a composite indicator of bacillary burden.
美国现行指南建议，由耐吡嗪酰胺的微生物（如牛分枝杆菌）引起的结核病（TB）的治疗时间要长于结核分枝杆菌所致结核病。我们比较了2006 - 2013年美国报告的牛分枝杆菌结核病患者和结核分枝杆菌结核病患者的治疗反应时间。我们纳入了诊断时接受标准四联药物治疗、有基因分型结果且痰培养呈阳性的肺结核患者。痰培养转阴时间定义为治疗开始日期与首次连续痰培养阴性日期之间的时间。我们分析了297例牛分枝杆菌结核病病例患者和30848例结核分枝杆菌结核病病例患者。治疗2个月后，71%的牛分枝杆菌结核病患者和65%的结核分枝杆菌结核病患者痰培养转为阴性。即使在控制了治疗给药类型、性别和细菌负荷综合指标后，牛分枝杆菌痰培养转阴的可能性仍高于结核分枝杆菌。
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