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孟加拉国迈门辛地区肺结核患者的抗结核药物耐药分布及模式。

Distribution and Pattern of Anti-Tubercular Drug Resistance in Patients with Pulmonary Tuberculosis in Mymensingh Region of Bangladesh.

机构信息

Dr Muhammad Saiful Hasan, Associate Professor, Department of Microbiology, Netrokona Medical College, Netrokona, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2022 Oct;31(4):1102-1107.

Abstract

Globally, the emergence of multidrug-resistant strains of Mycobacterium tuberculosis is an increasing problem that adversely affects patient care and public health. This cross sectional descriptive study was carried out in the Department of Microbiology, Mymensingh Medical College from January 2010 to December 2010 to isolate M. tuberculosis from smear-positive sputum samples by Lowenstein-Jensen (L-J) media and investigate the drug resistance pattern. Among 101 smear-positive cases 80(79.20%) yielded growth of Mycobacteria, 5(4.95%) were contaminated and 16(15.84%) showed no growth. Among 80 isolates 76(95.0%) were M. tuberculosis and the remaining 4(5.0%) were Non-tuberculous Mycobacteria (NTM). Out of 76 M. tuberculosis 27(35.52%) were resistant to at least one drug, 4(5.26%) to Isoniazid (INH), 1(1.32%) to Rifampicin (RMP), 8(10.53%) to Streptomycin (SM) and 0(0.0%) to Ethambutol (EMB) and multi-drug resistant tuberculosis (MDR-TB) was 9(11.84%). The present study creates the impression that fairly high rate of anti-tuberculosis drug resistance among the tuberculosis cases and also high MDR-TB (Resistant to both Rifampicin and Isoniazide). The emergence of MDR-TB poses significant trouble to TB control activities throughout the world. The complexity of MDR-TB operation makes it essential to produce new skills to design, plan, application and monitor interventions for the management of MDR-TB. More surveillance and immediate remedial interventions should be performed to combat the trouble of MDR-TB to the general population.

摘要

全球范围内,结核分枝杆菌多药耐药株的出现是一个日益严重的问题,对患者治疗和公共卫生造成了不利影响。本横断面描述性研究于 2010 年 1 月至 12 月在孟加拉国迈门辛医科大学微生物系进行,目的是通过 Lowenstein-Jensen(L-J)培养基从痰涂片阳性标本中分离结核分枝杆菌,并调查耐药模式。在 101 例痰涂片阳性病例中,80 例(79.20%)分枝杆菌生长,5 例(4.95%)污染,16 例(15.84%)无生长。在 80 株分离株中,76 株(95.0%)为结核分枝杆菌,其余 4 株(5.0%)为非结核分枝杆菌(NTM)。在 76 株结核分枝杆菌中,27 株(35.52%)至少对一种药物耐药,4 株(5.26%)对异烟肼(INH)耐药,1 株(1.32%)对利福平(RMP)耐药,8 株(10.53%)对链霉素(SM)耐药,0 株(0.0%)对乙胺丁醇(EMB)耐药,耐多药结核病(MDR-TB)为 9 株(11.84%)。本研究表明,结核病患者中抗结核药物耐药率相当高,且耐多药结核病(MDR-TB)(对利福平及异烟肼均耐药)的发病率也很高。MDR-TB 的出现给全球结核病控制活动带来了重大挑战。MDR-TB 情况复杂,因此必须培养新技能,以设计、规划、应用和监测管理 MDR-TB 的干预措施。应加强监测和及时补救干预措施,以防止 MDR-TB 对普通人群造成危害。

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