关紧水龙头：利用快速方法阻止俄罗斯联邦耐多药结核病的传播。
Turning Off the Tap: Using the FAST Approach to Stop the Spread of Drug-Resistant Tuberculosis in the Russian Federation.
机构信息
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts.
Partners in Health, Boston, Massachusetts.
出版信息
J Infect Dis. 2018 Jul 13;218(4):654-658. doi: 10.1093/infdis/jiy190.
BACKGROUND
We report the association of the FAST strategy (find cases actively, separate safely, and treat effectively) with reduction of hospital-based acquisition of multidrug-resistant tuberculosis in the Russian Federation.
METHODS
We used preintervention and postintervention cohorts in 2 Russian hospitals to determine whether the FAST strategy was associated with a reduced odds of converting MDR tuberculosis within 12 months among patients with tuberculosis susceptible to isoniazid and rifampin at baseline.
RESULTS
Sixty-three of 709 patients (8.9%) with isoniazid and rifampin-susceptible tuberculosis acquired MDR tuberculosis; 55 (12.2%) were in the early cohort, and 8 (3.1%) were in the FAST cohort. The FAST strategy was associated with a reduced odds (adjusted odds ratio, 0.16; 95% confidence interval, .07-.39) and 9.2% absolute reduction in the risk of MDR tuberculosis acquisition.
CONCLUSION
Use of the FAST strategy in 2 Russian hospitals was associated with significantly less MDR tuberculosis 12 months after implementation.
背景
我们报告了 FAST 策略（主动发现病例、安全隔离和有效治疗）与俄罗斯联邦减少医院获得性耐多药结核病之间的关联。
方法
我们使用了 2 家俄罗斯医院的干预前和干预后队列，以确定 FAST 策略是否与基线时对异烟肼和利福平敏感的结核病患者在 12 个月内发生耐多药结核病的可能性降低相关。
结果
709 例对异烟肼和利福平敏感的结核病患者中有 63 例（8.9%）发生耐多药结核病；55 例（12.2%）在早期队列中，8 例（3.1%）在 FAST 队列中。FAST 策略与降低耐多药结核病发病的可能性相关（调整后的优势比，0.16；95%置信区间，0.07-0.39），并使耐多药结核病发病的风险降低 9.2%。
结论
在 2 家俄罗斯医院使用 FAST 策略与实施后 12 个月耐多药结核病的发生率显著降低相关。
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