Miralles Martín P, Moreno Guillén S, Parras Vázquez F, Cosín Ochaita J, Cercenado Mansilla E, Ortega Calderón A, Bouza Santiago E
Unidad de Enfermedades Infecciosas-VIH, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Clin Esp. 1996 Jan;196(1):21-3.
To determine the prevalence of M. tuberculosis isolates resistant to drugs in a general hospital and to assess its association with HIV infection.
Susceptibility analysis of all isolates of M. tuberculosis in a 4-year period (1990-1993). The proportion method was used to study the susceptibility to eight drugs. To assess the association of resistance with HIV infection a crossing was made of patients records who had M. tuberculosis recovered and that of patients with positive serology to HIV.
Forty-two out of a total of 760 isolates (5.5%) were resistant to at least one drug, including isoniazid in 27 (3.3%), rifampin in 13 (1.6%), and pyrazinamide in 2 (0.2%). None of the isolates was resistant to ofloxacin. Twenty isolates (2.6%) were resistant to more than one drug and 9 (1.2%) were resistant to at least isoniazid and rifampin. Overall, 39% of resistance to one drug occurred in patients who had not received previous therapy with that drug. A greater incidence of resistant isolates was observed in HIV+ patients (7.3%) than in HIV- patients (4.6%), although this difference did not reach a statistical significance.
Drug resistance rate in M. tuberculosis isolates in our hospital is still low and apparently not associated with HIV infection.
确定综合医院中对药物耐药的结核分枝杆菌分离株的流行情况，并评估其与HIV感染的关联。
对4年期间（1990 - 1993年）所有结核分枝杆菌分离株进行药敏分析。采用比例法研究对8种药物的敏感性。为评估耐药性与HIV感染的关联，将结核分枝杆菌培养阳性患者的记录与HIV血清学阳性患者的记录进行交叉分析。
在总共760株分离株中，42株（5.5%）对至少一种药物耐药，其中27株（3.3%）对异烟肼耐药，13株（1.6%）对利福平耐药，2株（0.2%）对吡嗪酰胺耐药。没有分离株对氧氟沙星耐药。20株（2.6%）对一种以上药物耐药，9株（1.2%）对至少异烟肼和利福平耐药。总体而言，39%的对一种药物的耐药发生在未曾接受过该药物治疗的患者中。在HIV阳性患者中观察到的耐药分离株发生率（7.3%）高于HIV阴性患者（4.6%），尽管这种差异未达到统计学显著性。
我院结核分枝杆菌分离株的耐药率仍然较低，且显然与HIV感染无关。
