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中国贵州省某大型医院的耐药结核病耐药谱及趋势

Drug resistance profiles and trends in drug-resistant tuberculosis at a major hospital in Guizhou Province of China.

作者信息

Lan Yuanbo, Li Yuqin, Chen Ling, Zhang Jianyong, Zhang Hong

机构信息

Department of Respiratory Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563003, China,

Z-BioMed, Inc., Rockville, MD 20855, USA,

出版信息

Infect Drug Resist. 2019 Jan 10;12:211-219. doi: 10.2147/IDR.S188538. eCollection 2019.

Abstract

OBJECTIVES

Tuberculosis (TB) is the leading cause of death from infectious diseases in the world, with an estimated 1.6 million deaths from TB in 2017. The objectives of this study were to determine drug resistance profiles of clinical isolates and to analyze the trends in drug-resistant and multidrug-resistant tuberculosis (MDR-TB) from 2008 to 2015 at a major hospital in Guizhou, a high-TB burden and resource-limited province of China.

PATIENTS AND METHODS

A total of 462 clinical isolates were collected from patients with pulmonary TB during the period from January 2013 to December 2015 and used for determining drug resistance profiles against four first-line and six second-line anti-TB drugs, and the results were compared with those of two previous studies.

RESULTS

Exactly 4.4% of new and 44.1% of previously treated TB cases were MDR/rifampicin-resistant TB (RR-TB), which were higher than the 2017 global average numbers of 3.5% and 18%, respectively. There were many drug-resistant patterns among MDR-TB isolates and most of them were resistant to three or four anti-TB drugs. The trends in drug-resistant and MDR-TB declined at the hospital from 2008 to 2015.

CONCLUSION

Results of this study show that the prevalence of MDR/RR-TB at a major hospital in Guizhou is higher than the global average and confirm the existence of heterogeneity in drug resistance patterns of MDR-TB isolates. Additionally, three practical measures have played an important role in the overall decline of MDR-TB at the hospital from 2008 to 2015.

摘要

目的

结核病是全球传染病致死的首要原因,2017年估计有160万人死于结核病。本研究的目的是确定临床分离株的耐药谱,并分析2008年至2015年期间在中国结核病负担高且资源有限的贵州省一家大型医院的耐药和耐多药结核病(MDR-TB)趋势。

患者与方法

2013年1月至2015年12月期间,共收集了462例肺结核患者的临床分离株,用于确定对四种一线和六种二线抗结核药物的耐药谱,并将结果与之前的两项研究进行比较。

结果

新发病例中4.4%以及既往治疗病例中44.1%为MDR/利福平耐药结核病(RR-TB),分别高于2017年全球平均水平的3.5%和18%。MDR-TB分离株存在多种耐药模式,其中大多数对三种或四种抗结核药物耐药。2008年至2015年期间,该医院的耐药和MDR-TB趋势有所下降。

结论

本研究结果表明,贵州一家大型医院的MDR/RR-TB患病率高于全球平均水平,并证实MDR-TB分离株的耐药模式存在异质性。此外,三项实际措施在2008年至2015年期间该医院MDR-TB的总体下降中发挥了重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d226/6330984/685e2473a3c9/idr-12-211Fig1.jpg

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