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乌干达西南部诊断为肺结核的患者中利福平及异烟肼耐药情况。

Rifampicin and isoniazid drug resistance among patients diagnosed with pulmonary tuberculosis in southwestern Uganda.

机构信息

Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

Department of Microbiology and Immunology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda.

出版信息

PLoS One. 2021 Oct 29;16(10):e0259221. doi: 10.1371/journal.pone.0259221. eCollection 2021.

Abstract

Multidrug-resistant tuberculosis (MDR-TB) has become a major threat to the control of tuberculosis globally. Uganda is among the countries with a relatively high prevalence of tuberculosis despite significant control efforts. In this study, the drug resistance of Mycobacterium tuberculosis to rifampicin (RIF) and isoniazid (INH) was investigated among patients diagnosed with pulmonary tuberculosis in Southwestern Uganda. A total of 283 sputum samples (266 from newly diagnosed and 17 from previously treated patients), collected between May 2018 and April 2019 at four different TB diagnostic centres, were assessed for RIF and INH resistance using high-resolution melt curve analysis. The overall prevalence of monoresistance to INH and RIF was 8.5% and 11% respectively, while the prevalence of MDR-TB was 6.7%. Bivariate analysis showed that patients aged 25 to 44 years were at a higher risk of developing MDR-TB (cOR 0.253). Furthermore, among the newly diagnosed patients, the prevalence of monoresistance to INH, RIF and MDR-TB was 8.6%, 10.2% and 6.4% respectively; while among the previously treated cases, these prevalence rates were 5.9%, 23.5% and 11.8%. These rates are higher than those reported previously indicating a rise in MTB drug resistance and may call for measures used to prevent a further rise in drug resistance. There is also a need to conduct frequent drug resistance surveys, to monitor and curtail the development and spread of drug-resistant TB.

摘要

耐多药结核病(MDR-TB)已成为全球结核病控制的主要威胁。乌干达是结核病发病率相对较高的国家之一,尽管已采取了重大控制措施。在这项研究中,研究了乌干达西南部地区诊断为肺结核的患者分枝杆菌对利福平(RIF)和异烟肼(INH)的耐药性。总共评估了 283 份痰样本(266 份来自新诊断患者,17 份来自以前治疗过的患者),这些样本是在 2018 年 5 月至 2019 年 4 月期间在四个不同的结核病诊断中心收集的,采用高分辨率熔解曲线分析检测 RIF 和 INH 耐药性。异烟肼和利福平单耐药的总患病率分别为 8.5%和 11%,而耐多药结核病的患病率为 6.7%。双变量分析表明,25 至 44 岁的患者患耐多药结核病的风险更高(校正比值比 0.253)。此外,在新诊断的患者中,异烟肼、利福平和耐多药结核病的单耐药患病率分别为 8.6%、10.2%和 6.4%;而在以前治疗过的病例中,这些患病率分别为 5.9%、23.5%和 11.8%。这些比率高于以前的报告,表明 MTB 耐药性上升,可能需要采取措施防止耐药性进一步上升。还需要进行频繁的耐药性调查,以监测和遏制耐药性结核病的发展和传播。

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