在不太发达国家的医院住院患者中未被认可的Mycobacterium结核病细菌病
L C McDonald1, L K Archibald, S Rheanpumikankit
1Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Lancet (London, England)
|October 8, 1999
概括
结核病 (Mycobacterium tuberculosis) 血流感染通常在住院患者中未被识别,特别是那些感染艾滋病毒的人. 早期检测对于控制这种全球性公共卫生问题的传播至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 临床微生物学 临床微生物学
背景情况:
- 结核菌 (M. tuberculosis) 的鼻腔传染是全球重要的公共卫生问题.
- 在住院患者中早期识别M.结核病对于感染控制至关重要,但在艾滋病毒感染的个体中可能具有挑战性.
研究的目的:
- 调查发烧性住院患者中未被识别的Mycobacterium结核病细菌病的频率.
- 评估识别M.结核病感染的诊断挑战,特别是在HIV阳性患者中.
主要方法:
- 在泰国和马拉维的传染病和普通医院进行了前性血液培养调查.
- 发烧的成年住院患者 (下温度≥37.5°C或口腔温度≥38.0°C) 参与了菌根菌血培养和艾滋病毒检测.
- 标准的诊断测试,如胸部X射线和唾液涂抹,是基于临床判断的.
主要成果:
- 在344名注册患者中,34人 (10%) 患有M.结核病细菌病;所有人都感染了艾滋病毒.
- 在29名没有接受治疗的M.结核病细菌病患者中,只有45%的患者在胸部X射线图或唾液涂抹上显示了指示性结果.
- 这些患者中有很大一部分 (55%) 缺乏额外的诊断结果,咳是常见的症状 (81%).
结论:
- 肺结核菌血常常在低资源环境中的发烧性住院患者中未被识别,M.肺结核和HIV的患病率很高.
- 这项研究强调,需要在脆弱人群中改善M.结核病的诊断策略.
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