Toyota E, Yosizawa A, Takahara M, Tagawa K, Kobayashi N, Suzuki T, Kudo K, Kabe J, Arai T
Division of respiratory disease, International medical center of Japan, Tokyo.
Kekkaku. 1996 Jan;71(1):13-7.
We studied on the prevalence of drug-resistance among 65 homeless cases who were admitted and treated for active tuberculosis at the Nakano National Chest Hospital during the period from 1990 to 1992 and at the International Medical Center of Japan during the period from 1993 to 1994. Resistance to one or more first line antituberculous drug were revealed in 14 cases out of 65 (21.5%) in initially treated cases 6 out of 43, and in retreated cases 8 out of 22. The prevalence of drug resistance in this study was significantly higher compared with 2 out of 39 cases (5.1%) in our previous report during the period from 1986 to 1988. In these drug-resistant cases, multidrug-resistant cases, namely, resistant to at least 2 drugs including both INH and RFP were founded in 6 cases (9.2%). Compared with drug-sensitive cases, the negative convertion rate of bacilli was lower and the number of defalters was significantly larger. It was suggested that higher prevalence of drug-resistance and defalting from the adequate treatment in homeless cases of tuberculosis possibly makes the prognosis of drug-resistant tuberculosis worse and treatment of such cases more difficult.
我们研究了1990年至1992年期间在中野国立胸科医院以及1993年至1994年期间在日本国际医疗中心收治并治疗活动性肺结核的65例无家可归患者的耐药率。在65例初治患者中有14例（21.5%）对一种或多种一线抗结核药物耐药，其中43例中有6例，复治患者22例中有8例。本研究中的耐药率显著高于我们之前1986年至1988年期间报告的39例中的2例（5.1%）。在这些耐药病例中，发现6例（9.2%）为耐多药病例，即至少对包括异烟肼和利福平在内的2种药物耐药。与药物敏感病例相比，杆菌转阴率较低，违约人数显著较多。提示无家可归肺结核患者中较高的耐药率和未接受充分治疗可能会使耐药结核病的预后更差，此类病例的治疗更困难。
