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首页> 外文期刊>The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease >Rise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa
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Rise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa

机译：南非西开普的利福平单药耐药结核病的上升

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SETTING: Brewelskloof Hospital, Western Cape, South Africa. OBJECTIVES: To verify the perceived increase in rifampicin monoresistant tuberculosis (RMR-TB) in the Cape Winelands-Overberg region and to identify potential risk factors. DESIGN: A retrospective descriptive study of trends in RMR-TB over a 5-year period (2004-2008), followed by a case-control study of RMR and isoniazid (INH) monoresistant TB cases, diagnosed from April 2007 to March 2009, to assess for risk factors. RESULTS: The total number of RMR-TB cases more than tripled, from 31 in 2004 to 98 in 2008. The calculated doubling time was 1.63 years (95%CI 1.18-2.66). For the assessment of risk factors, 95 RMR-TB cases were objectively verified on genotypic and phenotypic analysis. Of 108 specimens genotypically identified as RMR cases, 13 (12%) were misidentified multidrugresistant TB. On multivariate analysis, previous use of antiretroviral therapy (OR 6.4, 95%CI 1.3-31.8), alcohol use (OR 4.8, 95%CI 2.0-11.3) and age ≥40 years (OR 5.8, 95%CI 2.4-13.6) were significantly associated with RMR-TB. CONCLUSION: RMR-TB is rapidly increasing in the study setting, particularly among patients with advanced human immunodeficiency virus (HIV) disease. Routine drug susceptibility testing should be considered in all TB-HIV co-infected patients, and absence of INH resistance should be confirmed phenotypically if genotypic RMR-TB is detected.
机译：地点：南非西开普Brewelskloof医院。目的：验证在开普酒乡-奥弗贝格地区发现的利福平单药耐药结核病（RMR-TB）的增加并确定潜在的危险因素。设计：一项回顾性描述性研究，研究了5年期间（2004-2008年）的RMR-TB趋势，然后进行了一项2007年4月至2009年3月确诊的RMR和异烟肼（INH）单药耐药结核病例的病例对照研究，评估风险因素。结果：RMR-TB病例总数增加了两倍多，从2004年的31例增加到2008年的98例。计算的倍增时间为1.63年（95％CI 1.18-2.66）。为了评估危险因素，通过基因型和表型分析客观证实了95例RMR-TB病例。基因型鉴定为RMR的108个标本中，有13个（12％）被误诊为耐多药结核病。在多变量分析中，先前曾使用过抗逆转录病毒疗法（OR 6.4，95％CI 1.3-31.8），饮酒（OR 4.8，95％CI 2.0-11.3）和年龄≥40岁（OR 5.8，95％CI 2.4-13.6）与RMR-TB显着相关。结论：RMR-TB在研究环境中正在迅速增加，特别是在患有晚期人类免疫缺陷病毒（HIV）疾病的患者中。所有结核病-HIV合并感染的患者均应考虑常规药敏试验，如果检测到基因型RMR-TB，应从表型上确认没有INH耐药性。

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