在流行病地区对耐药结核病的分类
A Van Rie1, R Warren, M Richardson
1Department of Paediatrics and Child Health, University of Stellenbosch, South Africa.
Lancet (London, England)
|July 13, 2000
概括
耐药结核病的传统分类是误导性的. 限制碎片长度多态 (RFLP) 显示,超过一半的病例中传播了耐药菌株,突出显示需要修订术语.
科学领域:
- 分子流行病学分子流行病学
- 传染病的传播是传染病的传播.
- 公共卫生监督是对公共卫生的监督.
背景情况:
- 耐药结核病的传统分类依赖于治疗史.
- 主要耐药性在历史上仅归因于耐药菌株的传播.
研究的目的:
- 评估耐药结核病中耐药菌株传播的贡献.
- 为了比较分子类型的结果与传统的临床分类.
主要方法:
- 在南非开普敦对63名耐药结核病患者的描述性研究.
- 使用限制片段长度多态 (RFLP) 进行菌株类型化.
- 将RFLP发现与传统患者分类进行比较.
主要成果:
- 在52%的耐药结核病病例中,限制片长多态 (RFLP) 确定了传播为原因.
- 多抗药结核病的传播比例高于单抗药结核病的传播比例 (64%).
- 传统的分类错误地确定了25名患者的传播.
结论:
- "获得药物耐药性"一词不准确地涵盖了真正的获得和传播.
- 错误分类可能导致监测,计划评估和治疗延迟有缺陷.
- 建议用"先前治疗的病例中的耐药性"取代"获得的耐药性".
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