The influence of epidemiologic factors on drug resistance rates in tuberculosis.
The influence of epidemiologic factors on drug resistance rates in tuberculosis.
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流行病学因素对结核病耐药率的影响。
DOI：
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发表时间：
1987
期刊：
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通讯作者：
P. Barnes
中科院分区：
文献类型：
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作者：
P. Barnes
我们评估了376例住院的培养证实的结核病患者的耐药率与各种流行病学因素之间的关系，其中前瞻性研究356例，回顾性研究20例。对332例患者进行了访谈。出生于美国、加拿大或欧洲的患者被认为属于I组。第二组包括出生于拉丁美洲、亚洲或非洲的患者，并细分为第二组（a），在美国居住超过10年的移民，和第二组（B），在美国居住不到10年的移民。在过去接受过抗结核治疗的70例患者中，第二组（n = 31）对异烟肼（INH）、链霉素（SM）和利福平（RIF）的耐药率极高：分别为39%、29%和19%。19%的人对INH和RIF都有耐药性。在I组（n = 39）中，INH、SM和RIF的耐药率分别为8%、5%和8%。在283例既往无抗结核治疗史的患者中，I组和II（a）组（n = 170）很少显示INH或RIF耐药。在来自拉丁美洲或亚洲的近期移民中[第II组（B），n = 113]，11.5%显示INH或RIF耐药，14%携带SM耐药微生物。因此，对估计耐药可能性最有帮助的3个变量是既往抗结核治疗史、原籍国和在美国居住的时间。
We evaluated the relationship between drug resistance rates and various epidemiologic factors in 376 hospitalized adults with culture-proved tuberculosis, studying 356 cases prospectively, 20 retrospectively. The patient was interviewed in 332 cases. Patients born in the United States, Canada, or Europe were considered to belong to Group I. Group II consisted of patients born in Latin America, Asia, or Africa and was subdivided into II(a), immigrants living in the United States for more than 10 yr, and II(b), those living here less than 10 yr. Of the 70 patients who had received antituberculosis therapy in the past, resistance rates in Group II (n = 31) to isoniazid (INH), streptomycin (SM), and rifampin (RIF) were extremely high: 39, 29, and 19%, respectively. Nineteen percent showed resistance to both INH and RIF. In Group I (n = 39), INH, SM, and RIF resistance rates were 8, 5, and 8%, respectively. Of 283 patients who gave no history of prior antituberculosis therapy, those in Groups I and II(a) (n = 170) rarely showed INH or RIF resistance. Among recent immigrants from Latin America or Asia [Group II(b), n = 113], 11.5% showed INH or RIF resistance and 14% harbored organisms resistant to SM. Thus, the 3 variables that are most helpful in estimating the likelihood of drug resistance are a history of prior antituberculosis therapy, country of origin, and duration of residence in the United States.