张蕾蕾 1金华 2冯菊英 1王建云 3宋琼 1张莉 1孙遵嬿1
作者信息
- 1. 730020甘肃省兰州市疾病预防控制中心
- 2. 730020甘肃省兰州市,甘肃中医药大学
- 3. 730000甘肃省兰州市,兰州市肺科医院
- 折叠
摘要
Abstract
Objective To analyze the reasons of the patients with multidrug-resistant tuberculosis (MDR-TB) excluded from the Tuberculosis Control Project supported by Global Fund,so as to provide evidences for the treatment of these patients.Methods The participants enrolled were 76 cases with MDR-TB selected from 770 suspicious cases in Lanzhou from March 2012 to June 2014.They were divided into included group(n=42) and non-included group(n=34) by the panel of experts based on the baseline characteristics,bacteria culture,results of auxiliary examination,and drug treatment history.The susceptibility to isoniazid(INH,H),rifampicin (RFP,R),ethambutol (EMB,E),streptomycin(SM,S),ofloxacin (OFLX,Ofx),kanamycin (KM,Km),amikacin (AMK,Am),capreomycin (CPM,Cm) was tested by the proportional method.Results Of the 34 patients in the non-included group,6 were young,19 were middle-aged,and 9 were aged.The age distribution and treatment history differed significantly between the two groups(P<0.05).The 34 patients in the non-included group had 9 kinds of antibiotic resistance combination;17 were only resistant to first-line anti-tuberculosis drugs,the first combination of antibiotic resistance spectrum was H+R+S(8 cases),and the second was H+R(6 cases);other 17 cases were resistant to both first-line and second-line anti-tuberculosis drugs,the first combination of antibiotic resistance spectrum was H+R+S+Ofx(8 cases),and the second was H+R+E+S+Ofx(5 cases).The 34 patients excluded from the Project was due to death(6 cases),refusing to receive that kind of treatment(4 cases),lost to follow up (2 cases),insisting on using the original treatment(2 cases),1 was excluded,detaining(8 cases),aged over 65 and with different chronic basic diseases(5 cases),severe liver or kidney injury or other comorbidities and complications(5 cases),the coming out time of results of antibiotic susceptibility was later than the included time of the Project(1 case).Conclusion It is necessary to pay great attention to using the second-line anti-tuberculosis drugs in the control and treatment of MDR-TB patients whose treatment was excluded from the Project.Besides,vulnerable population including elderly and detained patients should also be focused on.关键词
结核,抗多种药物性/老年人/抗结核药/全球基金耐多药结核病项目Key words
Tuberculosis/multidrug-resistant/Aged/Antitubercular agents/Global fund for MDR-TB分类
医药卫生
