Drug-resistant tuberculosis: Review of the worldwide situation and the WHO/IUATLD global surveillance project
Drug-resistant tuberculosis: Review of the worldwide situation and the WHO/IUATLD global surveillance project
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DOI：
10.1093/clinids/24.supplement_1.s121
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发表时间：
1997-01-01
影响因子：
11.8
通讯作者：
Raviglione, MC
中科院分区：
文献类型：
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作者：
Cohn, DL;Bustreo, F;Raviglione, MC
对抗分枝杆菌药物具有耐药性的结核分枝杆菌菌株的出现是一个世界性问题，其全球规模尚未得到很好的描述。我们回顾并列出了1985年至1994年间进行的63项抗结核药物耐药性调查。异烟肼单药治疗的原发性耐药率范围为0 - 16.9%（中位耐药率为4.1%）;链霉素为0.1%-23.5%（中位耐药率为3.5%）;利福平为0-3.0%（中位耐药率为0.2%）;乙胺丁醇为0-4.2%（中位耐药率为0.1%）。对这些药物的获得性耐药率高于原发性耐药率，如下：异烟肼，4.0%-53.7%（中位数，10.6%）;链霉素，0-19.4%（中位数，4.9%）;利福平，0-14.5%（中位数，2.4%）;乙胺丁醇，0-13.7%（中位数，1.8%）。报告的耐多药结核病发生率最高的国家是尼泊尔（48.0%）、印度古吉拉特邦（33.8%）、纽约市（30.1%）、玻利维亚（15.3%）和韩国（14.5%）。WHO（世界卫生组织）和IUATLD（国际结核病和肺病防治联盟）建立了一个全球耐药性监测项目，该项目基于标准流行病学方法，并通过广泛的参考实验室网络进行质量控制。准确的耐药性监测数据可用于评估和改进国家结核病规划。
The emergence of strains of Mycobacterium tuberculosis that are resistant to antimycobacterial agents is a worldwide problem whose global magnitude is not well described. We reviewed and tabulated 63 surveys of resistance to antituberculous drugs that were performed between 1985 and 1994. Rates of primary resistance to isoniazid, administered as a single agent, ranged from 0 to 16.9% (median rate, 4.1%); to streptomycin, 0.1%-23.5% (median, 3.5%); to rifampin, 0-3.0% (median, 0.2%); and to ethambutol, 0-4.2% (median, 0.1%). The rates of acquired resistance to these agents, which were higher than those of primary resistance, were as follows: isoniazid, 4.0%-53.7% (median rate, 10.6%); streptomycin, 0-19.4% (median, 4.9%); rifampin 0-14.5% (median, 2.4%); and ethambutol, 0-13.7% (median, 1.8%). The highest rates of multidrug-resistant tuberculosis have been reported in Nepal (48.0%), Gujarat, India (33.8%), New York City, (30.1%), Bolivia (15.3%), and Korea (14.5%). The WHO (World Health Organization) and the IUATLD (International Union Against Tuberculosis and Lung Disease) have established a global project of drug resistance surveillance that is based on standard epidemiological methods and quality control through an extensive network of reference laboratories. Accurate drug resistance surveillance data can be used to assess and improve national tuberculosis programs.