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2015年在利文斯通中心医院使用GeneXpert检测结核分枝杆菌患者利福平耐药情况:一项横断面探索性研究。

Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study.

作者信息

Masenga Sepiso K, Mubila Harrison, Hamooya Benson M

机构信息

University of Zambia, School of Health Sciences, P.o Box 50110, Lusaka, Zambia.

Pathology Laboratory department, Research section, Livingstone Central Hospital, P.o Box 60091, Livingstone, Zambia.

出版信息

BMC Infect Dis. 2017 Sep 22;17(1):640. doi: 10.1186/s12879-017-2750-9.

Abstract

BACKGROUND

Since the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015.

METHODS

This was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher's exact test.

RESULTS

The age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721).

CONCLUSION

We were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

摘要

背景

自从赞比亚最近引入GeneXpert用于检测结核病(TB)原发耐药和获得性耐药中的耐药突变以来,关于利福平耐药问题的文献记载很少,尤其是在该国结核病负担较高的情况下。本研究旨在确定2015年利文斯通中心医院结核病患者中利福平耐药的患病率。

方法

这是一项在利文斯通中心医院进行的横断面研究,我们回顾了152份记录(从2015年1月1日至2015年12月31日),涉及临床疑似结核病或确诊结核病的患者,其样本被送往实验室进行GeneXpert结核分枝杆菌/利福平检测。统计评估采用单样本比例检验和费舍尔精确检验。

结果

参与者年龄范围为8个月至73岁(中位数=34岁)。在有完整性别数据的参与者中,男性99人(66%),女性52人(34%)。结核病合并艾滋病毒感染率为98.3%(p<0.001)。利福平耐药率为5.9%,男性和女性之间无统计学显著差异(p=0.721)。

结论

我们的研究能够证明利文斯通中心医院存在利福平耐药的证据。因此,需要进一步深入研究并采取适当干预措施(即对耐药阳性患者进行密切随访和患者护理)。

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