Barnes P F
Am Rev Respir Dis. 1987 Aug;136(2):325-8. doi: 10.1164/ajrccm/136.2.325.
We evaluated the relationship between drug resistance rates and various epidemiologic factors in 376 hospitalized adults with culture-proved tuberculosis, studying 356 cases prospectively, 20 retrospectively. The patient was interviewed in 332 cases. Patients born in the United States, Canada, or Europe were considered to belong to Group I. Group II consisted of patients born in Latin America, Asia, or Africa and was subdivided into II(a), immigrants living in the United States for more than 10 yr, and II(b), those living here less than 10 yr. Of the 70 patients who had received antituberculosis therapy in the past, resistance rates in Group II (n = 31) to isoniazid (INH), streptomycin (SM), and rifampin (RIF) were extremely high: 39, 29, and 19%, respectively. Nineteen percent showed resistance to both INH and RIF. In Group I (n = 39), INH, SM, and RIF resistance rates were 8, 5, and 8%, respectively. Of 283 patients who gave no history of prior antituberculosis therapy, those in Groups I and II(a) (n = 170) rarely showed INH or RIF resistance. Among recent immigrants from Latin America or Asia [Group II(b), n = 113], 11.5% showed INH or RIF resistance and 14% harbored organisms resistant to SM. Thus, the 3 variables that are most helpful in estimating the likelihood of drug resistance are a history of prior antituberculosis therapy, country of origin, and duration of residence in the United States.
我们评估了376例经培养证实为肺结核的住院成年患者的耐药率与各种流行病学因素之间的关系，其中356例为前瞻性研究，20例为回顾性研究。对332例患者进行了访谈。出生在美国、加拿大或欧洲的患者被归为第一组。第二组由出生在拉丁美洲、亚洲或非洲的患者组成，并细分为II(a)组，即在美国居住超过10年的移民，以及II(b)组，即居住时间少于10年的移民。在过去接受过抗结核治疗的70例患者中，第二组（n = 31）对异烟肼（INH）、链霉素（SM）和利福平（RIF）的耐药率极高：分别为39%、29%和19%。19%的患者对INH和RIF均耐药。在第一组（n = 39）中，INH、SM和RIF的耐药率分别为8%、5%和8%。在283例无既往抗结核治疗史的患者中，第一组和II(a)组（n = 170）很少出现INH或RIF耐药。在来自拉丁美洲或亚洲的新移民中[II(b)组，n = 113]，11.5%出现INH或RIF耐药，14%携带对SM耐药的菌株。因此，在估计耐药可能性时最有帮助的三个变量是既往抗结核治疗史、原籍国和在美国的居住时间。
