Llerena Claudia, Zabaleta Angie, Valbuena Angélica, Murcia Martha
Laboratorio de Micobacterias, Subdirección Laboratorio Nacional de Referencia, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
Biomedica. 2017 Jan 24;37(1):96-103. doi: 10.7705/biomedica.v37i2.3204.
Tuberculosis is a health problem worldwide. The World Health Organization estimated 9.6 million new cases and 480,000 multirresistant cases for 2014. The assessment of resistance to quinolones and injectables was implemented only a few years ago, so its prevalence is not known.
To determine the prevalence of resistance to amikacin, capreomycin and ofloxacin in cases of tuberculosis resistant to isoniazid and/or rifampin during 2012-2013.
This was a cross-sectional study of 489 isolates resistant to isoniazid and/or rifampin. We used the Bactec MGITTM technique for susceptibility tests. For analyzing the rate of resistance, we grouped cases according to the history of treatment with second line drugs.
In the 438 new cases, the drug that showed greater overall resistance was kanamycin with 7.1 % (95% CI: 4.6 to 9.6). In 51 previously treated cases, this highest resistance was 27.5 % (95% CI:14.2 to 40.7). The overall resistance was higher in cases with a history of treatment with quinolones and injectables. We found seven cases of extremely resistant tuberculosis.
This study demonstrates the presence of resistance to second line drugs in people with drug-resistant tuberculosis with and without previous treatment with quinolones and/or injectables, these latter having a higher percentage of resistance. For that reason, it is essential to perform susceptibility testing and analyze this information routinely.
结核病是一个全球性的健康问题。世界卫生组织估计2014年有960万新发病例和48万多重耐药病例。对喹诺酮类药物和注射用药物耐药性的评估仅在几年前才开始实施，因此其流行情况尚不清楚。
确定2012 - 2013年对异烟肼和/或利福平耐药的结核病病例中对阿米卡星、卷曲霉素和氧氟沙星的耐药率。
这是一项对489株对异烟肼和/或利福平耐药菌株的横断面研究。我们使用Bactec MGITTM技术进行药敏试验。为了分析耐药率，我们根据二线药物治疗史对病例进行分组。
在438例新发病例中，总体耐药率最高的药物是卡那霉素，为7.1%（95%可信区间：4.6至9.6）。在51例既往治疗过的病例中，最高耐药率为27.5%（95%可信区间：14.2至40.7）。有喹诺酮类药物和注射用药物治疗史的病例总体耐药率更高。我们发现了7例极度耐药结核病病例。
本研究表明，无论有无喹诺酮类药物和/或注射用药物既往治疗史，耐多药结核病患者中均存在对二线药物的耐药情况，后者的耐药百分比更高。因此，进行药敏试验并常规分析这些信息至关重要。
