埃塞俄比亚西南部奥罗米亚地区曾接受过治疗的结核病例中分离出的复合结核分枝杆菌对吡嗪酰胺的耐药性

IF 1.9 Q3 INFECTIOUS DISEASES
Getu Balay , Kedir Abdella , Wakjira Kebede , Mulualem Tadesse , Zegeye Bonsa , Mekidim Mekonnen , Misikir Amare , Gemeda Abebe
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引用次数: 0

摘要

目的吡嗪酰胺(PZA)药敏试验对于制定以证据为基础的病例管理算法非常重要。方法 2021 年 6 月至 11 月,吉马大学分枝杆菌学研究中心(MRC-JU)使用 BACTEC MGIT 960 对先前治疗过的结核病病例中分离出的 66 个结核分枝杆菌复合体(MTBC)进行了 PZA 表型药敏试验(DST)。使用的是 SPSS 软件包第 21 版。采用卡方检验比较了各组间 PZA 耐药性比例的差异。本研究纳入的 66 个 MTBC 分离株(49 个耐利福平,17 个对利福平敏感)中,31.8% 对 PZA 具有耐药性。与对利福平敏感的患者相比,曾接受过利福平耐药治疗的肺结核患者对 PZA 产生耐药性的比例几乎高出三倍(38.8% 对 11.8%,p = 0.039)。据记录,23%(15/65)的参与者出现了不利的治疗结果。PZA耐药患者出现不利治疗结果的几率几乎是PZA敏感患者的四倍(aOR 4.2,95 % CI:1.13-15.3)。大多数对 PZA 产生耐药性的肺结核病例治疗效果不佳。PZA药敏试验应纳入耐多药肺结核诊断算法,以改善对这些患者的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia

Objective

Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia.

Methods

A Phenotypic Drug Susceptibility Testing (DST) of PZA with BACTEC MGIT 960 was conducted at the Mycobacteriology Research Center of Jimma University (MRC-JU) from June to November 2021 on sixty-six Mycobacterium tuberculosis complex (MTBC) isolates from previously treated TB cases. SPSS software package version 21 was used. The differences in the proportion of PZA resistance between the groups were compared using the chi squared test. Logistic regression was used to identify the association between PZA resistance and treatment outcomes.

Results

Among 66 MTBC isolates (49 rifampicin-resistant and 17 rifampicin-sensitive) included in this study, 31.8 % were resistant to PZA. The proportion of PZA resistance was almost three times higher in previously treated TB cases with rifampicin resistance than in rifampicin-sensitive patients (38.8 % vs. 11.8 %, p = 0.039). An unfavorable treatment outcome was documented for 23 % (15/65) of the participants. Patients with PZA resistance were almost four times more likely to have an unfavorable treatment outcome than patients with PZA sensitive (aOR 4.2, 95 % CI: 1.13–15.3).

Conclusions

The prevalence of PZA resistance was high compared to the pooled PZA resistance estimated worldwide. The majority of TB cases with PZA resistance had an unfavorable treatment outcome. PZA susceptibility testing should be included in the multidrug-resistant TB diagnostic algorithm to improve management of these patients.

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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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