MMWR Morb Mortal Wkly Rep. 1998 Sep 18;47(36):759-61.
In 1996, the incidence of tuberculosis (TB) in Colombia was 26.5 per 100,000 population, and mortality was 3.4 per 100,000; in comparison, the incidence in Buenaventura, a port town on the Pacific coast, was 90.5 per 100,000, and mortality was 9.4 per 100,000. The prevalence of multidrug-resistant tuberculosis (MDR-TB) (i.e., Mycobacterium tuberculosis isolates resistant to at least isoniazid [INH] and rifampin [RIF]) was not known because susceptibility testing is not performed routinely, and data on drug resistance for the country have not been collected systematically. During October-November 1997, at the request of the Secretary of Health in Cali, Colombia, the International Center for Training and Medical Investigation in Cali performed sputum cultures for M. tuberculosis and drug-susceptibility testing on isolates from 18 (75%) of 24 TB patients in Buenaventura who were known to be clinically unresponsive to standard TB treatment. MDR-TB was identified in 12 (67%) of these patients, four of whom subsequently died. In March 1998, the International Center for Training and Medical Investigation and the Secretary of Health of Colombia invited CDC to participate in an investigation of these patients with MDR-TB. This report summarizes the findings of this investigation, which indicated that inconsistencies in treatment may have contributed to this outbreak, and provides recommendations for the prevention and control of MDR-TB in Buenaventura.
1996年，哥伦比亚结核病（TB）的发病率为每10万人26.5例，死亡率为每10万人3.4例；相比之下，太平洋沿岸港口城市布埃纳文图拉的发病率为每10万人90.5例，死亡率为每10万人9.4例。耐多药结核病（MDR-TB，即结核分枝杆菌分离株至少对异烟肼[INH]和利福平[RIF]耐药）的患病率未知，因为未常规进行药敏试验，且该国的耐药数据未系统收集。1997年10月至11月，应哥伦比亚卡利市卫生部长的请求，卡利市国际培训与医学调查中心对布埃纳文图拉24例已知对标准结核病治疗无临床反应的结核病患者中的18例（75%）进行了结核分枝杆菌痰培养和分离株药敏试验。在这些患者中，12例（67%）被鉴定为耐多药结核病，其中4例随后死亡。1998年3月，国际培训与医学调查中心和哥伦比亚卫生部长邀请美国疾病控制与预防中心（CDC）参与对这些耐多药结核病患者的调查。本报告总结了此次调查结果，表明治疗不一致可能导致了此次疫情，并为布埃纳文图拉耐多药结核病的预防和控制提供了建议。
