孟加拉国肺结核患者中异化物耐药性模式:一项探索性研究
Syed Mohammad Mazidur Rahman1, Pushpita Samina2, Tanjina Rahman1
1Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
概括
在孟加拉国,耐异酸结核病 (Hr-TB) 的患病率很高,超过了耐多药结核病的患病率. 早期发现Hr-TB对于有效的治疗和控制策略至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 孟加拉国等高负担国家的结核病 (结核病) 研究往往优先考虑耐利芬辛结核病,忽视耐异化结核病 (Hr-TB).
- 结核病患者的异化 (INH) 耐药性可能导致治疗失败和疾病进展,如果不及时识别.
研究的目的:
- 确定孟加拉国肺结核患者中异化物耐药性患病率.
- 为了比较Hr-TB患者与药物敏感结核病患者的特征.
主要方法:
- 从孟加拉国9个结核病查和治疗中心的1084名Xpert阳性肺结核患者中收集了唾液样本.
- 对998种培养阳性分离物进行了药物敏感性测试,以评估INH耐药性.
- 分析了人口和临床数据,以比较Hr-TB和对药物敏感的结核病患者群体.
主要成果:
- 任何INH抗性的总比率为6.4%,在以前接受治疗的结核病患者 (21.1%) 中显著高于新诊断的患者 (5.2%).
- 霍氏结核的患病率为4.5%,在以前接受过治疗的患者中 (6.6%) 与新诊断的患者 (4.3%) 相比也更高.
- 在研究人群中,Hr-TB的患病率 (4.5%) 是多抗药性结核病 (MDR-TB) (1.9%) 的两倍多.
结论:
- 这项研究强调了孟加拉国Hr-TB的大量和令人担忧的流行率,超过了MDR-TB的发病率.
- 迫切需要在全国范围内实施世卫组织推的分子诊断工具,以快速检测INH耐药性.
- 及时诊断和对Hr-TB患者的适当治疗对于改善患者的治疗结果和结核病控制至关重要.
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