From the Department of Medical Laboratory (Al-Shahrani), Department of Pulmonary Medicine (Younis, Fan), King Fahd Armed Forces Hospital, Jeddah; Saudi Ministry of Health (Hakami), King Fahd Central Hospital; from the Biochemistry Department (Jeraiby), Faculty of Medicine, Jazan University, Jazan; and from Department of Clinical Laboratory Sciences (Alraey), College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia.
Saudi Med J. 2021 Jul;42(7):728-734. doi: 10.15537/smj.2021.42.7.20200797.
To estimate the prevalence mono-resistant tuberculosis (MR-TB) and multidrug resistant TB (MDR-TB), and evaluate the risk factors associated with the drug-resistant tuberculosis (DR-TB).
A descriptive, retrospective study was applied, utilizing the TB patients' medical records at King Fahd Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia. The records of patients notified between 2000 and 2018 were reviewed and culture positive cases for species were included. Moreover, the risk factors included were age, gender, smoking history, renal disease, liver disease, hyperbilirubinemia, diabetes mellitus, and human immunodeficiency virus (HIV).
Nine hundred and one cases in entirety were involved in the research, out of which 193 had drug-resistant tuberculosis (DR-TB) (21.4%). Out of the 21.4% DR-TB, 91.7% were MR-TB and 8.3% were MDR-TB. The highest MR prevalence was for pyrazinamide at 33.4%, while the lowest resistance was for ethambutol at 7.1%. For the risk factors of drug-resistant TB, only age depicted a statistically significant (<0.01) but weak negative (r= -0.145) correlation with anti-TB drug resistance.
Rates of DR-TB reported in the study are considered higher compared to the recently reported national and international rates. According to the results, only younger people are at risk of developing DR-TB. Moreover, genetic mutation may play a role in drug resistance among our cases specifically for pyrazinamide monoresistance.
估计单耐药结核病（MR-TB）和耐多药结核病（MDR-TB）的患病率，并评估与耐药结核病（DR-TB）相关的危险因素。
本研究采用描述性、回顾性研究方法，利用沙特阿拉伯吉达的法赫德国王武装部队医院（KFAFH）的结核患者病历。对 2000 年至 2018 年期间报告的病例记录进行了审查，并纳入了种培养阳性的病例。此外，纳入的危险因素包括年龄、性别、吸烟史、肾脏疾病、肝脏疾病、高胆红素血症、糖尿病和人类免疫缺陷病毒（HIV）。
本研究共涉及 901 例病例，其中 193 例患有耐药结核病（DR-TB）（21.4%）。在 21.4%的 DR-TB 中，91.7%为耐多药结核（MDR-TB），8.3%为单耐药结核（MR-TB）。吡嗪酰胺的耐药率最高，为 33.4%，而乙胺丁醇的耐药率最低，为 7.1%。对于耐药结核病的危险因素，只有年龄与抗结核药物耐药性呈统计学显著（<0.01）但较弱的负相关（r= -0.145）。
与最近报告的全国和国际耐药率相比，本研究报告的 DR-TB 发生率较高。根据结果，只有年轻人有发展 DR-TB 的风险。此外，基因突变可能在我们的病例中对吡嗪酰胺单耐药起作用。
