Multidrug-resistant tuberculosis at an HIV testing center in Haiti
Multidrug-resistant tuberculosis at an HIV testing center in Haiti
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DOI：
10.1097/01.aids.0000206505.09159.9a
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发表时间：
2006-02-14
期刊：
影响因子：
3.8
通讯作者：
Fitzgerald, DW
中科院分区：
文献类型：
--
作者：
Joseph, P;Severe, P;Fitzgerald, DW
目的：结核病是发展中国家HIV/AIDS的主要机会性感染。我们调查了艾滋病毒自愿咨询和检测（VCT）中心在太子港，Haiti.Design和方法：耐多药（MDR）结核病的患病率进行了横断面流行病学研究，在VCT中心。所有报告咳嗽至少5天的患者均接受结核筛查，包括痰培养。结果：2000年1月至2002年12月，330例患者的结核分枝杆菌分离株进行了药物敏感性试验。281例原发性结核病患者中有16例（6%）记录了MDR结核病，49例复发性结核病患者中有10例（20%）记录了MDR结核病。在原发病患者中，115例HIV感染者中有11例（10%）有MDR-结核病，而166例HIV阴性患者中有5例（3%）有MDR-结核病（风险比3.2; 95%可信区间1.1 - 8.9; P = 0.0331）。合并HIV感染的原发性肺结核患者比HIV阴性患者更容易出现多药耐药。在发展中国家的艾滋病毒检测中心，对结核病感染控制措施的密切关注对于预防院内耐多药结核病传播至关重要。措施可能包括适当的通风、户外座位、紫外线灯和现场快速结核病筛查。(C)2006年利平科特威廉姆斯&威尔金斯。
Objective: Tuberculosis is the major opportunistic infection of HIV/AIDS in developing countries. We investigated the prevalence rate of multidrug-resistant (MDR) tuberculosis at an HIV voluntary counseling and testing (VCT) center in Port-au-Prince, Haiti.Design and methods: A cross-sectional prevalence study of MDR-tuberculosis was conducted at a VCT Center. All patients reporting at least 5 days of cough were screened for tuberculosis, including sputum culture. All Mycobacteria tuberculosis isolates underwent drug susceptibility testing.Results: Between January 2000 and December 2002, isolates from 330 patients underwent drug susceptibility testing. MDR-tuberculosis was documented in 16 (6%) of 281 patients with primary tuberculosis and 10 (20%) of 49 patients with recurrent tuberculosis. In patients with primary disease, 11 (10%) of 115 HIV-infected patients had MDR-tuberculosis compared with five (3%) of 166 HIV-negative patients, (risk ratio 3.2; 95% confidence interval 1.1 -8.9; P = 0.0331).Conclusion: Multidrug resistance was prevalent among patients found to have pulmonary tuberculosis at an HIV testing center in Port-au-Prince. Patients with primary pulmonary tuberculosis who were HIV-co-infected were more likely to have multidrug resistance than HIV-negative patients. Assiduous attention to tuberculosis infection control measures at HIV testing centers in developing countries is critical to prevent nosocomial MDR-tuberculosis transmission. Measures may include appropriate ventilation, outdoor seating, ultra-violet lights, and rapid on-site screening for tuberculosis. (C) 2006 Lippincott Williams & Wilkins.