Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance
Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance
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DOI：
10.1016/s0140-6736(09)60331-7
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发表时间：
2009-05-01
期刊：
影响因子：
168.9
通讯作者：
Raviglione, Mario
中科院分区：
文献类型：
--
作者：
Wright, Abigail;Zignol, Matteo;Raviglione, Mario
背景 全球抗结核药物耐药性项目自 1994 年以来一直在收集数据。这项研究提供了全球耐药性程度的最新数据。方法 2002 年至 2007 年间，从 83 个国家和地区的 90 726 名患者中收集了药物敏感性数据。结果的标准化收集可以在国家之间和国家内部进行比较。在可能的情况下，还获得了艾滋病毒状况和对二线药物耐药性的数据。实验室数据由超国家结核病参考实验室网络保证质量。调查结果 新发结核病病例中对任何药物的耐药率中位数为 11.1% (IQR 7.0-22.3)。新发结核病病例中的多重耐药率在 8 个国家为 0%，在中国两个省为 7%，在北马里亚纳群岛为 11.1%（尽管只报告了 2 例），在前苏联 9 个国家为 6.8% 到 22.3%，其中摩尔多瓦为 19.4%，阿塞拜疆巴库为 22.3%（接受调查国家的中位数为 1.6%，IQR） 0.6-3.9）。趋势分析显示，1994年至2007年间，韩国、俄罗斯托木斯克州和奥廖尔州耐多药结核病新发病例患病率大幅上升，但爱沙尼亚和拉脱维亚则保持稳定。在香港和美国，所有结核病病例中耐多药结核病的患病率均有所下降。 37 个国家和地区报告了广泛耐药 (XDR) 结核病的代表性数据。前苏联的五个国家均报告了 25 例或以上 XDR 结核病病例，耐多药结核病病例的患病率在 6.6% 至 23.7% 之间。 解读 耐多药结核病仍然对中国各省和前苏联国家的结核病控制构成威胁。许多国家，特别是非洲国家，都没有耐药性数据，这强调需要开发更简单的结核病耐药性监测方法。资助全球项目：美国国际开发署和礼来公司。耐药性调查：国家结核病规划、荷兰政府、全球抗击艾滋病、结核病和疟疾基金、日本国际协力事业团和 Kreditanstalt Fur Wiederaufbau。
Background The Global Project on Anti-Tuberculosis Drug Resistance has been gathering data since 1994. This study provides the latest data on the extent of drug resistance worldwide.Methods Data for drug susceptibility were gathered from 90 726 patients in 83 countries and territories between 2002 and 2007. Standardised collection of results enabled comparison both between and within countries. Where possible, data for HIV status and resistance to second-line drugs were also obtained. Laboratory data were quality assured by the Supranational Tuberculosis Reference Laboratory Network.Findings The median prevalence of resistance to any drug in new cases of tuberculosis was 11.1% (IQR 7.0-22.3). The prevalence of multidrug resistance in new tuberculosis cases ranged from 0% in eight countries to 7% in two provinces in China, 11.1% in Northern Mariana Islands (although reporting only two cases), and between 6.8% and 22.3% in nine countries of the former Soviet Union, including 19.4% in Moldova and 22.3% in Baku, Azerbaijan (median for countries surveyed 1.6%, IQR 0.6-3.9). Trend analysis showed that between 1994 and 2007, the prevalence of multidrug-resistant (MDR) tuberculosis in new cases increased substantially in South Korea and in Tomsk Oblast and Orel Oblast, Russia, but was stable in Estonia and Latvia. The prevalence of MDR tuberculosis in all tuberculosis cases decreased in Hong Kong and the USA. 37 countries and territories reported representative data on extensively drug-resistant (XDR) tuberculosis. Five countries, all from the former Soviet Union, reported 25 cases or more of XDR tuberculosis each, with prevalence among MDR-tuberculosis cases ranging between 6.6% and 23.7%.Interpretation MDR tuberculosis remains a threat to tuberculosis control in provinces in China and countries of the former Soviet Union. Data on drug resistance are unavailable in many countries, especially in Africa, emphasising the need to develop easier methods for surveillance of resistance in tuberculosis.Funding Global Project: United States Agency for International Development and Eli Lilly and Company. Drug resistance surveys: national tuberculosis programmes, the Government of the Netherlands, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Japan International Cooperation Agency, and Kreditanstalt fur Wiederaufbau.