Hongthiamthong P, Chuchottaworn C, Amatayakul N
Central Chest Hospital, Department of Communicable Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
J Med Assoc Thai. 1994 Jul;77(7):363-7.
The emergence of drug resistant tuberculosis has been reported from many countries which have had epidemics of human immunodeficiency virus (HIV) infection. This study was conducted at the Central Chest Hospital, Thailand in order to determine the prevalence of drug resistance before treatment in Thai HIV-infected tuberculosis patients. From the Statistics and Registration Unit, pulmonary tuberculosis patients with HIV seropositivity were matched in terms of age and gender with control cases who attended the tuberculosis clinic on the same day. Results of sensitivity test were obtained from record cards in the Microbiology Section. The method for determining the sensitivity test was absolute concentration. During the study period from January 1988 to December 1993, 798 patients were registered as having tuberculosis and HIV infection. Only 406 sensitivity tests were available before treatment and resisted to Isoniazid 56 (13.8%), rifampicin 36 (8.9%), ethambutol 6 (1.5%), streptomycin 64 (15.8%) and Multidrug resistant (MDR)- TB 11 (2.7%). In the control group, 475 tests were available and resisted to isoniazid 61 (12.8%), rifampicin 52 (10.9%), ethambutal 2 (0.4%), streptomycin 46 (9.7%) and MDR-TB 13 (2.7%). The prevalence of resistance to each drug was not significantly different except for streptomycin. We concluded that the prevalence of antituberculous drug resistance among Thai HIV-infected tuberculosis patients was not higher than among general tuberculosis patients.
许多存在人类免疫缺陷病毒(HIV)感染流行情况的国家都报告了耐药结核病的出现。本研究在泰国中央胸科医院开展,目的是确定泰国HIV感染的结核病患者治疗前的耐药率。从统计与登记部门获取了HIV血清学阳性的肺结核患者信息,并按照年龄和性别与同日到结核病门诊就诊的对照病例进行匹配。药敏试验结果来自微生物科的记录卡。药敏试验的方法是绝对浓度法。在1988年1月至1993年12月的研究期间,有798名患者登记患有结核病和HIV感染。治疗前仅获得406份药敏试验结果,其中对异烟肼耐药的有56例(13.8%),对利福平耐药的有36例(8.9%),对乙胺丁醇耐药的有6例(1.5%),对链霉素耐药的有64例(15.8%),耐多药结核病(MDR-TB)有11例(2.7%)。在对照组中,有475份试验结果,对异烟肼耐药的有61例(12.8%),对利福平耐药的有52例(10.9%),对乙胺丁醇耐药的有2例(0.4%),对链霉素耐药的有46例(9.7%),MDR-TB有13例(2.7%)。除链霉素外,每种药物的耐药率差异无统计学意义。我们得出结论,泰国HIV感染的结核病患者中抗结核药物耐药率并不高于普通结核病患者。