Characteristics and outcome of multidrug-resistant tuberculosis in a low-incidence area
Characteristics and outcome of multidrug-resistant tuberculosis in a low-incidence area
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DOI：
10.1016/j.medmal.2018.04.400
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发表时间：
2018-10-01
影响因子：
5
通讯作者：
Boutoille, D.
中科院分区：
文献类型：
--
作者：
Gaborit, B. J.;Revest, M.;Boutoille, D.
目标。-分析在法国低流行地区治疗的耐多药结核病（MDR-TB）患者的特征，并确定耐药的危险因素。我们还分析了结核治疗的疗效和耐受性。2002-2013年期间，回顾性纳入了法国西部（GERICCO集团所属医院）诊断的所有耐多药结核病患者，随访期一直持续到2016年。一项病例对照研究（1:2），根据年龄、性别和诊断年份进行匹配，以评估同一时期耐多药结核病患者和治疗药物敏感结核病的对照组的社会人口统计学和临床数据、治疗策略和结果。-在134名结核病患者中，44名为耐多药结核病，90名为药物敏感结核病。44例耐多药结核病患者（35例耐多药，9例广泛耐药）中，33例（75%）为男性；中位年龄为33岁；27人（61%）出生在东欧。先前治疗失败在格鲁吉亚广泛耐药结核病患者中更为常见（8/9）。在多变量分析中，危险接触者和既往结核病史与耐多药结核病相关。治疗失败与MDR/XDR-TB和军用tb相关。-在法国西部，耐多药结核病更常发生在来自高风险国家的近期移民中，这些移民以前有与其他耐多药结核病患者有危险接触史或以前结核病治疗失败。(C) 2018 Elsevier Masson SAS。版权所有。
Objectives. - To characterize multidrug-resistant tuberculosis (MDR-TB) patients treated in a low endemic area in France and to determine risk factors for resistance. We also analyzed the efficacy and tolerability of tuberculosis (TB) treatment.Methods. - Between 2002-2013, all MDR-TB patients diagnosed in western France (hospitals belonging to the GERICCO group) were retrospectively included, with a follow-up period running until 2016. A case-control study (1:2), matched according to age, sex, and year of diagnosis, was performed to assess socio-demographic and clinical data, treatment strategies, and outcomes for the MDR-TB patients and controls treated for drug-susceptible tuberculosis during the same period.Results. - Of 134 TB patients, 44 were MDR-TB and 90 were drug-susceptible TB. Of the 44 MDR-TB patients (35 MDR and nine extensively drug-resistant [XDR]), 33 (75%) were males; the median age was 33 years; and 27 (61%) were born in Eastern Europe. Prior treatment failure was more frequently reported for XDR-TB (8/9) in Georgian patients. In multivariate analysis, risk contacts and prior TB history were associated with MDR-TB. Treatment failure was associated with MDR/XDR-TB and miliary TB.Conclusion. - In western France, MDR-TB more frequently occurred in recent migrants from high-risk countries with a previous history of at-risk contact with other MDR-TB patients or previous TB treatment failure. (C) 2018 Elsevier Masson SAS. All rights reserved.