Multidrug- and extensively drug-resistant tuberculosis, Germany.
Multidrug- and extensively drug-resistant tuberculosis, Germany.
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DOI：
10.3201/eid1411.080729
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发表时间：
2008-11
影响因子：
11.8
通讯作者：
Lange, Christoph
中科院分区：
文献类型：
--
作者：
Eker, Barbara;Ortmann, Johannes;Migliori, Giovanni B.;Sotgiu, Giovanni;Muetterlein, Ralf;Centis, Rosella;Hoffmann, Harald;Kirsten, Detlef;Schaberg, Tom;Ruesch-Gerdes, Sabine;Lange, Christoph
德国TBNET的一项调查显示，在最佳情况下，耐多药结核和广泛耐药结核晚期病例可以实现较高的持续培养转化率。我们在2004-2006年间评估了与德国多药耐药(MDR)和广泛耐药(XDR)结核病(TB)相关的风险因素和治疗结果。在4,557例培养阳性的结核病例中，177例(4%)结核分枝杆菌分离株被确认为耐多药结核；另有7例(0.15%)符合广泛耐药结核的标准。在这184名患者中，148名(80%)出生在前苏联国家。与耐多药结核病患者相比，广泛耐药结核病患者的住院时间更长(平均±SD202±130vs.123±81天；p=0.015)，对所有一线药物的耐药率更高(36%vs.86%；p=0.013)。在这184名患者中，74名(40%)接受了利奈唑胺治疗。整个队列的治疗成功率从59%(耐多药结核病59%，广泛耐药结核病57%)到明确结果的87%(n=125；耐多药结核病89%，广泛耐药结核病80%)不等。广泛的药敏试验以及在住院管理条件下二线和三线药物的可获得性，使得耐多药和广泛耐药结核病的治疗成功率相对较高。
A survey by the TBNET in Germany shows that, under optimal circumstances, high sustained culture conversion rates can be achieved in advanced cases of MDR TB and XDR TB. We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004–2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean ± SD 202 ± 130 vs. 123 ± 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB.
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影响因子：
158.5
作者：
Espinal, MA;Laszlo, A;Raviglione, MC
通讯作者：
Raviglione, MC
影响因子：
11.8
作者：
Kim, Hye-Ryoun;Hwang, Seung Sik;Yim, Jae-Joon
通讯作者：
Yim, Jae-Joon
影响因子：
4.9
作者：
Richter, Elvira;Ruesch-Gerdes, Sabine;Hillemann, Doris
通讯作者：
Hillemann, Doris
影响因子：
24.3
作者：
Migliori, G. B.;Besozzi, G.;Raviglione, M. C.
通讯作者：
Raviglione, M. C.
影响因子：
5.2
作者：
Fortún, J;Martín-Dávila, P;Moreno, S
通讯作者：
Moreno, S