在短期治疗耐利芬素结核病时获得的耐药性
Xinchang Chen1, Cui Cai2, Lingyun Song1
1Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
概括
较短的抗利芬素结核病 (RR-TB) 疗法带有获得性耐药性 (ADR) 的风险,特别是在缺乏坚持的情况下. 早期的不良反应可能标志着治疗效率低于最佳水平,需要进一步调查.
科学领域:
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 对抗利芬素结核病 (RR-TB) 的较短治疗方案是一个显著的进步.
- 然而,在这些较短的治疗方案中,关于获得的耐药性 (ADR) 的数据有限.
研究的目的:
- 为了调查获得药物耐药性 (ADR) 的发生率和模式,在与较短的治疗方案治疗的耐利素结核病 (RR-TB) 患者中.
- 探索ADR,治疗坚持和治疗结果之间的潜在关联.
主要方法:
- 全基因组测序用于检测中国TB-TRUST系列试验的参与者中与药物耐药性相关的突变.
- 参与者接受了无贝达基林的口服疗法,WHO推的注射剂含有疗法,或基于他们的耐药性概况的贝达基林口服疗法.
- 获得药物耐药性 (ADR) 通过分析从序列分离物中预定义的耐药性相关基因组中的突变来确定.
主要成果:
- 在114名参与者中,16人 (14.0%) 经历了至少一个ADR事件,其中金胺,贝达奎林和诺是最常见的药物.
- 发生ADR事件的中位数是治疗开始后17天.
- 获得药物耐药性 (ADR) 在治疗坚持不良的参与者中明显更频繁 (31.1%对11.2%,p=0.048).
结论:
- 较短的RR-TB治疗方案与获得药物耐药性 (ADR) 的风险相关.
- 治疗坚持不良可能会增加ADR发展的可能性.
- 早期出现ADR可能表明治疗方案的效力不足,需要进一步研究其临床影响和最佳管理策略.
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