Ausina V, Riutort N, Viñado B, Manterola J M, Ruiz Manzano J, Rodrigo C, Matas L, Giménez M, Tor J, Roca J
Microbiology Laboratory, Sta. Cruz and San Pablo Hospital, Barcelona, Spain.
Eur J Clin Microbiol Infect Dis. 1995 Feb;14(2):105-10. doi: 10.1007/BF02111867.
From January 1988 to October 1992, the primary resistance to first-line antituberculous drugs in 501 tuberculous patients was evaluated prospectively. Three-hundred and seventeen patients were HIV-negative and 184 were HIV-positive; these patients had several different clinical forms of tuberculosis. Moreover, the acquired resistance to antituberculous drugs was studied in 295 non-AIDS patients and in 42 AIDS patients with evidence of antecedent tuberculosis treatment. The data indicated that during these five years there was no consistent and clear-cut trend toward greater frequency of primary drug resistance to any of the first-line antituberculous drugs. Primary drug resistance in HIV-positive patients (7.1%) did not differ significantly (p > 0.05) from that found in HIV-negative patients (8.2%). Among HIV-positive patients, the acquired drug resistance pattern was similar to that detected in HIV-negative patients although the frequency of resistance in the former (69%) was significantly higher (p < 0.01). During the study, resistance to isoniazid was almost constant in the acquired-resistance cases and was frequently associated with resistance to other drugs. Furthermore, the acquired resistance to isoniazid was often of a higher level (1 to 10 mg/l) than the primary resistance (0.2 mg/l), and those strains were usually catalase and peroxidase negative.
1988年1月至1992年10月，对501例结核病患者一线抗结核药物的原发性耐药情况进行了前瞻性评估。317例患者HIV阴性，184例患者HIV阳性；这些患者有几种不同的临床结核病形式。此外，还对295例非艾滋病患者和42例有既往抗结核治疗证据的艾滋病患者进行了抗结核药物获得性耐药研究。数据表明，在这五年中，对任何一线抗结核药物的原发性耐药频率没有一致且明确的增加趋势。HIV阳性患者的原发性耐药率（7.1%）与HIV阴性患者（8.2%）相比，差异无统计学意义（p>0.05）。在HIV阳性患者中，获得性耐药模式与HIV阴性患者相似，尽管前者的耐药频率（69%）显著更高（p<0.01）。在研究期间，获得性耐药病例中对异烟肼的耐药情况几乎恒定，且常与对其他药物的耐药相关。此外，获得性异烟肼耐药水平（1至10mg/l）通常高于原发性耐药（0.2mg/l），且这些菌株通常过氧化氢酶和过氧化物酶阴性。
