Berliner D S, Haupt A
Aviat Space Environ Med. 1987 Jan;58(1):83-5.
In 1981, the Korean National Institute of Health (KNIH) reported that 17% of all tuberculosis patients had primary resistance to isoniazid while an additional 17% acquired isoniazid resistance during chemotherapy. This 34% isoniazid resistance rate in the Republic of Korea, where an estimated 6-8% of the total population have active tuberculosis, poses significant concerns regarding management of U.S. military health care beneficiaries who develop tuberculosis or have tuberculosis skin test conversion while residing in or after departure from Korea. To address this issue, the prevalence of Korean acquired isoniazid resistance was estimated in U.S. beneficiaries by performing antibiotic sensitivities on all positive cultures from October 1981 through December 1982. Of 42 patient isolates, six were isoniazid resistant (14.3%). When the data was analyzed further, it was determined that as many as 9.5% of those U.S. beneficiaries infected had primary isoniazid resistance. This is higher than the most recent U.S. population-based drug resistance study, in which 6.9% of tuberculosis patients had primary drug resistance. This data comparison points toward the need for judicious management of Korean acquired infections and skin test conversions. Emphasis is on criteria necessary to warrant use of chemotherapeutic agents other than isoniazid to prevent further introduction of resistant organisms into locales where isoniazid resistance is not as prevalent as reported in Korea.
1981年，韩国国立卫生研究院（KNIH）报告称，所有结核病患者中有17%对异烟肼具有原发性耐药性，另有17%在化疗期间获得了异烟肼耐药性。在韩国，估计总人口的6%-8%患有活动性结核病，34%的异烟肼耐药率引发了人们对美国军事医疗保健受益人的管理的重大担忧，这些受益人在韩国居住期间或离开韩国后患上结核病或结核菌素皮肤试验出现阳转。为解决这一问题，通过对1981年10月至1982年12月期间所有阳性培养物进行抗生素敏感性试验，估计了美国受益人中韩国获得性异烟肼耐药性的流行情况。在42例患者分离株中，有6例对异烟肼耐药（14.3%）。进一步分析数据时发现，那些受感染的美国受益人中多达9.5%具有原发性异烟肼耐药性。这一比例高于美国最近一项基于人群的耐药性研究，在该研究中，6.9%的结核病患者具有原发性耐药性。这种数据比较表明，有必要对韩国获得性感染和皮肤试验阳转进行审慎管理。重点是确定除异烟肼之外使用化疗药物以防止耐药菌进一步传入异烟肼耐药性不像韩国报告的那样普遍的地区所必需的标准。
