骨关节结核病的耐药性:来自特有病区的研究
Amartya Gain1, Anil K Jain1, Manpreet Bhalla2
1Orthopaedics, University College of Medical Sciences, New Delhi, IND.
Cureus
|September 27, 2023
概括
骨关节结核病的耐药性显著,12.5%的患者对关键的抗结核药物表现出耐药性. 早期的分子诊断对于及时治疗耐药结核病至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 整形外科 整形外科 整形外科
背景情况:
- 骨关节结核病的诊断和治疗具有挑战性,特别是在流行地区.
- 耐药性显著影响结核病的治疗结果.
- 了解阻力模式对于有效的管理策略至关重要.
研究的目的:
- 确定来自流行区的骨关节结核病患者对抗结核药物的耐药性发生率.
- 评估各种实验室方法的诊断准确性,以检测结核病.
- 在研究的患者队列中确定特定的耐药性概况.
主要方法:
- 临床放射学诊断的骨关节结核病患者 (n=40) 被纳入.
- 样品 (,组织,突液) 经过了酸快细菌 (AFB) 染色,液体培养,基因病理学和分子测试 (CBNAAT,LPA).
- 对13种抗结核药物进行了药物敏感性测试 (DST),包括一线和二线药物.
主要成果:
- 基于弹的核酸放大测试 (CBNAAT) 显示诊断准确率为90%.
- 药物耐药性的总体发病率为12.5%,包括多重耐药性 (MDR) 和前广泛耐药性 (XDR) 病例.
- 特定药物耐药性包括伊索尼亚 (INH) 的15.4%,里方素 (RIF) 的11.1%,勒沃素 (LEV) 的7.6%.
结论:
- 没有单一的诊断方法是足够的; 建议使用实验室测试的组合.
- 对于诊断,CBNAAT和组织病理学是有价值的,特别是在有限的样本.
- 该研究强调需要在骨关节结核病中进行全面的耐药性监测.
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