Department of Environmental and Occupational Health, Abu Dhabi Public Health Center, Abu Dhabi, United Arab Emirates.
Department of Pathology and Infectious Diseases, Khalifa University, Abu Dhabi, United Arab Emirates.
Front Public Health. 2024 Jun 14;12:1244353. doi: 10.3389/fpubh.2024.1244353. eCollection 2024.
The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in the United Arab Emirates (UAE) to 204 per 100,000 in Djibouti. The national surveillance data from the Middle East and North Africa (MENA) region on the epidemiology and antimicrobial resistance trends of TB, including MDR-TB remains scarce.
A retrospective 12-year analysis of = 8,086 non-duplicate diagnostic complex (MTB complex) isolates from the UAE was conducted. Data were generated through routine patient care during the 2010-2021 years, collected by trained personnel and reported by participating surveillance sites to the UAE National Antimicrobial Resistance (AMR) Surveillance program. Data analysis was conducted with WHONET, a windows-based microbiology laboratory database management software developed by the World Health Organization Collaborating Center for Surveillance of Antimicrobial Resistance, Boston, United States (https://whonet.org/).
A total of 8,086 MTB-complex isolates were analyzed. MTB-complex was primarily isolated from respiratory samples (sputum 80.1%, broncho-alveolar lavage 4.6%, pleural fluid 4.1%). Inpatients accounted for 63.2%, including 1.3% from ICU. Nationality was known for 84.3% of patients, including 3.8% Emiratis. Of UAE non-nationals, 80.5% were from 110 countries, most of which were Asian countries. India accounted for 20.8%, Pakistan 13.6%, Philippines 12.7%, and Bangladesh 7.8%. Rifampicin-resistant MTB-complex isolates (RR-TB) were found in 2.8% of the isolates, resistance to isoniazid, streptomycin, pyrazinamide, and ethambutol, was 8.9, 6.9, 3.4 and 0.4%, respectively. A slightly increasing trend of resistance among MTB-complex was observed for rifampicin from 2.5% (2010) to 2.8% (2021).
Infections due to MTB-complex are relatively uncommon in the United Arab Emirates compared to other countries in the MENA region. Most TB patients in the UAE are of Asian origin, mainly from countries with a high prevalence of TB. Resistance to first line anti-tuberculous drugs is generally low, however increasing trends for MDR-TB mainly rifampicin linked resistance is a major concern. MDR-TB was not associated with a higher mortality, admission to ICU, or increased length of hospitalization as compared to non-MDR-TB.
东地中海区域办事处（EMRO）区域占全球所有结核病（TB）病例的近 8%，TB 发病率从阿联酋的每年每 10 万人 1 例到吉布提的 204 例不等。中东和北非（MENA）区域关于结核病的流行病学和抗微生物药物耐药性趋势的国家监测数据，包括耐多药结核病（MDR-TB）仍然很少。
对来自阿联酋的 8086 例非重复诊断性复杂（MTB 复合体）分离株进行了为期 12 年的回顾性分析。数据是通过 2010 年至 2021 年期间的常规患者护理产生的，由经过培训的人员收集，并由参与监测的地点报告给阿联酋国家抗微生物药物耐药性（AMR）监测计划。数据分析使用 WHONET 进行，这是一种由美国波士顿世界卫生组织合作中心开发的基于 Windows 的微生物学实验室数据库管理软件（https://whonet.org/）。
共分析了 8086 例 MTB 复合体分离株。MTB 复合体主要从呼吸道样本中分离（痰液 80.1%，支气管肺泡灌洗液 4.6%，胸腔积液 4.1%）。住院患者占 63.2%，其中包括 ICU 中的 1.3%。84.3%的患者的国籍已知，其中包括 3.8%的阿联酋人。在非阿联酋国民中，80.5%来自 110 个国家，其中大多数来自亚洲国家。印度占 20.8%，巴基斯坦占 13.6%，菲律宾占 12.7%，孟加拉国占 7.8%。发现利福平耐药 MTB 复合体分离株（RR-TB）占分离株的 2.8%，异烟肼、链霉素、吡嗪酰胺和乙胺丁醇的耐药率分别为 8.9%、6.9%、3.4%和 0.4%。从 2010 年的 2.5%到 2021 年的 2.8%，观察到 MTB 复合体对利福平的耐药性呈略有上升趋势。
与 MENA 区域的其他国家相比，阿联酋的 MTB 复合体感染相对较少。阿联酋的大多数结核病患者来自亚洲，主要来自结核病高发国家。一线抗结核药物的耐药性一般较低，但主要与利福平相关的耐多药结核病（MDR-TB）的上升趋势令人担忧。与非 MDR-TB 相比，MDR-TB 与死亡率更高、入住 ICU 或住院时间延长无关。
