George R B, Farley T A, DeGraw C F, Owens M W
Department of Medicine, LSU School of Medicine-Shreveport, USA.
J La State Med Soc. 1998 Dec;150(12):587-95.
The incidence of tuberculosis in the United States declined steadily until 1985 when increases were seen, in part due to the AIDS epidemic. Although the decline resumed in 1992, tuberculosis remains a public health problem in Louisiana and nationally. In Louisiana in 1997, HIV infection was present in 14% of persons with tuberculosis whose HIV status was known. In that year there were 16 cases of tuberculosis that were resistant to at least one first-line anti-tuberculous drug. Infection with Mycobacterium tuberculosis is diagnosed with the tuberculin skin test; the size of induration considered positive varies with the risk status of the person tested. TB infection in immunocompetent persons under age 35 is treated with 6 months of isoniazid. TB disease is generally treated with 4 drugs until antimicrobial sensitivities are known. Directly observed therapy is an inexpensive way to ensure compliance and is routinely used for patients in Louisiana.
美国结核病发病率一直稳步下降，直到1985年出现上升，部分原因是艾滋病流行。尽管1992年又恢复下降，但结核病在路易斯安那州乃至全国仍然是一个公共卫生问题。1997年在路易斯安那州，已知HIV感染状况的结核病患者中有14%感染了HIV。同年有16例结核病患者至少对一种一线抗结核药物耐药。结核分枝杆菌感染通过结核菌素皮肤试验诊断；判定为阳性的硬结大小因受检者的风险状况而异。35岁以下免疫功能正常者的结核感染用异烟肼治疗6个月。结核病一般用4种药物治疗，直到了解抗菌药敏情况。直接观察治疗是确保患者依从性的一种低成本方法，在路易斯安那州常规用于患者。
