John G T, Mukundan U, Vincent L, Jacob C K, Shastry J C
Christian Medical College, Vellore, Tamil Nadu, India.
Natl Med J India. 1995 Sep-Oct;8(5):211-2.
After renal transplantation, patients have an up to 5% chance of being infected with Mycobacterium tuberculosis and there are reports from western countries of a 24% mortality if the infection is drug resistant. We investigated primary drug resistance in renal transplant recipients in Vellore, Tamil Nadu.
Between January 1987 and December 1993 we studied 695 patients (who had received 717 renal allografts) for evidence of tuberculosis, and performed drug sensitivity tests.
Forty-three patients had culture-proven infection with Mycobacterium tuberculosis of whom 40 had drug sensitivity tests done. Initial drug resistance was seen from 1991. Rifampicin resistance was seen in 2, 1 and 4 patients and isoniazid resistance in 1, 2 and 2 patients in 1991, 1992 and 1993, respectively of the 23 isolates tested for drug susceptibility. Multi-drug resistance was seen in 1 and 2 patients in 1992 and 1993.
This is probably the first report in India of primary drug resistance of Mycobacterium tuberculosis in renal allograft recipients. It is a cause for concern as it may indicate a large reservoir of drug-resistant patients in the community.
肾移植术后患者感染结核分枝杆菌的几率高达5%，西方国家有报道称，如果感染的是耐药菌，死亡率可达24%。我们对泰米尔纳德邦韦洛尔地区肾移植受者的原发性耐药情况进行了调查。
1987年1月至1993年12月期间，我们对695例患者（接受了717次肾移植）进行了结核病证据研究，并进行了药敏试验。
43例患者经培养证实感染结核分枝杆菌，其中40例进行了药敏试验。原发性耐药始于1991年。在1991年、1992年和1993年，分别对23株进行药敏试验的菌株中，有2例、1例和4例对利福平耐药，1例、2例和2例对异烟肼耐药。1992年和1993年分别有1例和2例患者出现多重耐药。
这可能是印度首例关于肾移植受者结核分枝杆菌原发性耐药的报告。这令人担忧，因为它可能表明社区中存在大量耐药患者。
