High prevalence of multidrug-resistant tuberculosis in Georgia
High prevalence of multidrug-resistant tuberculosis in Georgia
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DOI：
10.1016/j.ijid.2008.03.012
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发表时间：
2008-11-01
影响因子：
8.4
通讯作者：
Blumberg, Henry M.
中科院分区：
文献类型：
--
作者：
Mdivani, Nino;Zangaladze, Ekaterina;Blumberg, Henry M.
背景：结核病（TB）已成为格鲁吉亚国家一个严重的公共卫生问题。然而，很少或没有数据存在的耐药结核病，包括多药耐药（MDR）-TB，在格鲁吉亚。目的：评估耐药TB的患病率和危险因素。2001年1月1日至2004年12月31日在格鲁吉亚的4个哨点（第比利斯、祖格迪迪、库塔伊西和巴统）对疑似肺结核患者进行了前瞻性调查。结果：在1422例疑似肺结核患者中，996例（70.0%）培养阳性; 931/996（93.5%）进行了药物敏感试验。总体而言，64.0%的患者（48.3%的新病例和85.3%的复治病例）对≥ 1种一线抗结核药物耐药的结核分枝杆菌培养呈阳性。耐多药结核病的总体流行率为28.1%（新诊断患者的10.5%和复治病例的53.1%）。在多变量分析中，耐多药结核病的危险因素包括：（患病率（PR）= 5.28，95% CI 3.95-7.07），注射吸毒史结论：耐多药结核病在格鲁吉亚已成为一个严重的公共卫生问题，并将对结核病控制策略产生重大影响。(C)2008年国际传染病学会。由Elsevier Ltd.出版。保留AR权利。
Background: Tuberculosis (TB) has emerged as a serious public health problem in the country of Georgia. However, little or no data exist on rates and risk factors for drug-resistant TB, including multidrug-resistant (MDR)-TB, in Georgia.Objective: To assess the prevalence and risk factors for drug-resistant TB.Methods: A cross-sectional. prospective survey of patients with suspected pulmonary TB was carried out at four sentinel sites (Tbilisi, Zugdidi, Kutaisi, and Batumi) in Georgia between January 1, 2001 and December 31, 2004.Results: Among 1422 patients with suspected pulmonary TB, 996 (70.0%) were culture positive; 931/996 (93.5%) had drug susceptibility testing performed. Overall, 64.0% of patients (48.3% of new and 85.3% of retreatment cases) had positive cultures for Mycobacterium tuberculosis resistant to >= 1 first-line antituberculosis drugs. The overall prevalence of MDR-TB was 28.1% (10.5% of newly diagnosed patients and 53.1% of retreatment cases). In multivariate analysis, risk factors for MDR-TB included: being a retreatment case (prevalence ratio (PR) = 5.28, 95% CI 3.95-7.07), history of injection drug use (PR = 1.59, 95% CI 1.21-2.09), and female gender (PR = 1.36, 95% CI 1.12-1.65).Conclusions: MDR-TB has emerged as a serious public health problem in Georgia and will greatly impact TB control strategies. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. AR rights reserved.