2017年加拿大的结核病耐药情况

Tuberculosis drug resistance in Canada: 2017.

作者信息

LaFreniere M, Hussain H, Vachon J

机构信息

Centre for Communicable Disease and Infection Control, Public Health Agency of Canada, Ottawa, ON.

Dalla Lana School of Public Health, University of Toronto, Toronto, ON.

出版信息

Can Commun Dis Rep. 2018 Nov 1;44(11):290-296. doi: 10.14745/ccdr.v44i11a04.

DOI:10.14745/ccdr.v44i11a04

PMID:30996691

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6449088/

Abstract

BACKGROUND

Drug-resistant tuberculosis (TB) is a global public health issue. To monitor this in Canada, surveillance systems have been in place for the last 20 years.

OBJECTIVE

To describe drug resistance patterns among TB isolates in Canada in 2017 by type of resistance as well as geographic location, demographic data and origin and to compare current data to those of the previous 10 years.

METHODS

Data were derived and analyzed from two sources. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) is an isolate-based laboratory surveillance system and was used to obtain information on the results of drug susceptibility testing (DST) as well as province or territory, sex and age of the individual from which the sample originated. The Canadian Tuberculosis Reporting System (CTBRS) is a case-based surveillance system with information on active and retreatment TB cases in Canada and was used to derive origin data, which is defined as either foreign-born, Canadian-born Indigenous or Canadian-born non-Indigenous. Analysis was descriptive and compared with data from these two sources for 2007-2016.

RESULTS

In 2017, 1,515 TB isolates were tested for resistance to anti-TB drugs, with 123 (8.1%) demonstrating resistance to any first-line anti-TB drug. Of these, 103 were monoresistant, six were polyresistant and 14 were multidrug-resistant tuberculosis (MDR-TB). No extensively drug-resistant tuberculosis (XDR-TB) isolates were reported. Drug resistance was reported in seven provinces/territories (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and New Brunswick). There were 63 isolates from females with drug resistance (9.5%) and 60 isolates from males with drug resistance (7.0%). Drug resistance was found in a greater percentage of isolates among those aged 25-34 (n=29, 23.6%). By origin, 1,072 (11%) foreign-born TB cases reported between 2005 and 2015 were drug-resistant. Among the Canadian-born non-Indigenous and Canadian-born Indigenous TB cases, 143 (9%) and 54 (2%) were drug-resistant, respectively. Compared with previous years, the number of isolates tested increased slightly (from 1,267 to 1,515); however, there was a decrease in the percentage of isolates with reported drug resistance (from 10.5% in 2007 to 8.1% in 2017).

CONCLUSION

In 2017, TB drug resistance rates remained low in Canada.

摘要

背景

耐多药结核病是一个全球性的公共卫生问题。为在加拿大对此进行监测，过去20年一直设有监测系统。

目的

按耐药类型、地理位置、人口统计学数据及来源描述2017年加拿大结核病分离株的耐药模式，并将当前数据与前10年的数据进行比较。

方法

数据来源于两个来源并进行分析。加拿大结核病实验室监测系统（CTBLSS）是一个基于分离株的实验室监测系统，用于获取药物敏感性试验（DST）结果以及样本来源个体的省份或地区、性别和年龄信息。加拿大结核病报告系统（CTBRS）是一个基于病例的监测系统，包含加拿大活动性和复治结核病病例的信息，用于获取来源数据，来源数据定义为出生在国外、加拿大出生的原住民或加拿大出生的非原住民。分析采用描述性方法，并与2007 - 2016年这两个来源的数据进行比较。

结果

2017年，对1515株结核杆菌进行了抗结核药物耐药性检测，其中123株（8.1%）对任何一线抗结核药物呈现耐药。其中，103株为单耐药，6株为多耐药，14株为耐多药结核病（MDR - TB）。未报告广泛耐药结核病（XDR - TB）分离株。七个省/地区（不列颠哥伦比亚省、艾伯塔省、萨斯喀彻温省、马尼托巴省、安大略省、魁北克省和新不伦瑞克省）报告了耐药情况。有63株耐药分离株来自女性（9.5%），60株耐药分离株来自男性（7.0%）。在25 - 34岁人群中，耐药分离株的比例更高（n = 29，23.6%）。按来源划分，2005年至2015年报告的1072例出生在国外的结核病病例中有耐药情况。在加拿大出生的非原住民和加拿大出生的原住民结核病病例中，分别有143例（9%）和54例（2%）存在耐药情况。与前几年相比，检测的分离株数量略有增加（从1267株增至1515株）；然而，报告有耐药情况的分离株比例有所下降（从2007年的10.5%降至2017年的8.1%）。