Survival of civilian and prisoner drug-sensitive, multi- and extensive drug- resistant tuberculosis cohorts prospectively followed in Russia.
Survival of civilian and prisoner drug-sensitive, multi- and extensive drug- resistant tuberculosis cohorts prospectively followed in Russia.
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DOI：
10.1371/journal.pone.0020531
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Drobniewski FA
中科院分区：
文献类型：
--
作者：
Balabanova Y;Nikolayevskyy V;Ignatyeva O;Kontsevaya I;Rutterford CM;Shakhmistova A;Malomanova N;Chinkova Y;Mironova S;Fedorin I;Drobniewski FA
在俄罗斯萨马拉进行了一项长期观察性研究，以评估一组非多药耐药结核病(Non-MDRTB)和多药耐药结核病(MDRTB)平民和监狱患者以及一名平民广泛耐药结核病(XDRTB)队列的生存和死亡风险因素。该地区MDRTB和XDRTB感染率分别为54.8%和11.1%。半数(50%)的MDRTB患者和大多数(71%)的非MDRTB患者在5年时仍然活着。超过一半(58%)的患者在确诊为XDRTB后两年内死亡。在多因素分析中，再治疗(HR = 1.61，95%CI 1.04，2.49)和MDRTB(HR = 1.67，95%CI 1.17，2.39)与非MDR/MDRTB队列中的死亡显著相关。年龄对生存率的影响相对较小(HR = 为1.01，95%CI为1.00，1.02)。没有特定的因素影响XDRTB患者的生存，尽管这组HIV感染的患者与HIV阴性的患者的中位生存时间较短(185天对496天)。MDRTB和XDRTB菌株以北京科为主(分别占84%和92%)。RpoB突变(81/92密码子531；88.8%)、katG突变(91/92 S315T突变，98.9%)和inha基因突变分别是利福平和异烟肼耐药的主要原因，gyrA QRDR区突变是氟喹诺酮类耐药的主要原因(68/92；73.5%)。XDRTB的发病率高得惊人。以前的结核病治疗周期和耐多药是死亡率的重要危险因素。XDRTB患者的生存期很短，特别是对HIV感染的患者。耐药菌株以北京家系为主。
A long-term observational study was conducted in Samara, Russia to assess the survival and risk factors for death of a cohort of non-multidrug resistant tuberculosis (non-MDRTB) and multidrug resistant tuberculosis (MDRTB) civilian and prison patients and a civilian extensive drug-resistant tuberculosis (XDRTB) cohort. MDRTB and XDRTB rates of 54.8% and 11.1% were identified in the region. Half (50%) of MDRTB patients and the majority of non-MDRTB patients (71%) were still alive at 5 years. Over half (58%) of the patients died within two years of establishing a diagnosis of XDRTB. In the multivariate analysis, retreatment (HR = 1.61, 95%CI 1.04, 2.49) and MDRTB (HR = 1.67, 95%CI 1.17, 2.39) were significantly associated with death within the non-MDR/MDRTB cohort. The effect of age on survival was relatively small (HR = 1.01, 95%CI 1.00, 1.02). No specific factor affected survival of XDRTB patients although median survival time for HIV-infected versus HIV-negative patients from this group was shorter (185 versus 496 days). The majority of MDRTB and XDRTB strains (84% and 92% respectively) strains belonged to the Beijing family. Mutations in the rpoB (codon 531 in 81/92; 88.8%), katG (mutation S315T in 91/92, 98.9%) and inhA genes accounted for most rifampin and isoniazid resistance respectively, mutations in the QRDR region of gyrA for most fluroquinolone resistance (68/92; 73.5%). Alarmingly high rates of XDRTB exist. Previous TB treatment cycles and MDR were significant risk factors for mortality. XDRTB patients' survival is short especially for HIV-infected patients. Beijing family strains comprise the majority of drug-resistant strains.
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影响因子：
3.7
作者：
He GX;Xie YG;Wang LX;Borgdorff MW;van der Werf MJ;Fan JH;Yan XL;Li FB;Zhang XZ;Zhao YL;van den Hof S
通讯作者：
van den Hof S
影响因子：
14.2
作者：
Nikolayevskyy, V. V.;Brown, T. J.;Drobniewski, F. A.
通讯作者：
Drobniewski, F. A.
影响因子：
9.4
作者：
Kwara, A;Schiro, R;Crawford, JT
通讯作者：
Crawford, JT
DOI：
10.1164/ajrccm.159.3.9804147
发表时间：
1999-03-01
影响因子：
24.7
作者：
Murray, J;Sonnenberg, P;Godfrey-Faussett, P
通讯作者：
Godfrey-Faussett, P
影响因子：
9.4
作者：
Gopaul, Krishna K.;Brown, Timothy J.;Drobniewski, Francis A.
通讯作者：
Drobniewski, Francis A.