Anastasakos V, Skouras V, Moschos C, Tsikrika S, Karabela S, Marinou I, Vogiatzakis E, Konstantinou K, Papavasiliou A, Kalomenidis I
Department of Critical Care & Pulmonary Medicine, Medical School of Athens University, Evangelismos General Hospital, Athens.
Department of Pulmonary Medicine, 401 General Army Hospital of Greece, Athens.
Int J Tuberc Lung Dis. 2017 Mar 1;21(3):309-313. doi: 10.5588/ijtld.16.0155.
Data on the relationship between pleural tuberculosis (TB) and anti-tuberculosis drug resistance are scarce.
To determine the patterns of drug resistance among pleural Mycobacterium tuberculosis isolates in Greece and the incidence of tuberculous pleural effusion (TPE) among patients with multidrug-resistant (MDR) or extensively drug-resistant (XDR) pulmonary TB.
Drug susceptibility testing (DST) results recorded in the database of the National Reference Centre for Tuberculosis in Athens, Greece, over a 9-year period (2003-2011) were reviewed. Chest X-rays from hospitalised patients with pulmonary MDR/XDR-TB during the same period were also reviewed for the presence of TPE.
Resistance to at least one first-line drug was observed in 11% of the cases (MDR-TB 3%, XDR-TB 1%), while 29% of the patients with pulmonary MDR/XDR-TB presented with TPE during the course of their disease, the majority ipsilateral to the lung lesions, which responded to guided anti-tuberculosis treatment.
The prevalence of drug resistance among pleural M. tuberculosis isolates in Greece highlights the importance of DST prior to treatment selection in TPE patients. In our study population, TPE that developed in one third of the patients with pulmonary MDR/XDR-TB usually resolved with DST-guided anti-tuberculosis treatment.
关于胸膜结核（TB）与抗结核药物耐药性之间关系的数据很少。
确定希腊胸膜结核分枝杆菌分离株的耐药模式以及耐多药（MDR）或广泛耐药（XDR）肺结核患者中结核性胸腔积液（TPE）的发生率。
回顾了希腊雅典国家结核病参考中心数据库中记录的9年期间（2003 - 2011年）的药物敏感性试验（DST）结果。还回顾了同期住院的MDR/XDR肺结核患者的胸部X光片，以检查是否存在TPE。
11%的病例观察到对至少一种一线药物耐药（MDR-TB为3%，XDR-TB为1%），而29%的MDR/XDR肺结核患者在病程中出现TPE，大多数与肺部病变同侧，经针对性抗结核治疗后有反应。
希腊胸膜结核分枝杆菌分离株的耐药率表明在TPE患者选择治疗前进行DST的重要性。在我们的研究人群中，三分之一的MDR/XDR肺结核患者出现的TPE通常通过DST指导的抗结核治疗得以缓解。
