在尼日利亚东南部阿巴基利基4英里的诺思和圣帕特里克医院就诊的肺结核患者耐多药结核病的耐药率分布

IF 7.6 2区 工程技术 Q1 CHEMISTRY, APPLIED
Chinenye Esther Okoro-Ani, C. Akujobi, I. Udoh, S. Ibhawaegbele, C. Ezema, U. Ezeugwu, O. Dozie-Nwakile, A. Okpe
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引用次数: 0

摘要

结核病是有记载的最古老的人类疾病之一,尽管世界各地都在使用减毒活疫苗和几种抗生素,但它仍然是传染病中最大的杀手之一。本研究旨在评估尼日利亚东南部Nnamdi Azikiewe大学教学医院(NAUTH) Nnewi和St Patrick 's Hospital Mile 4 Abakaliki的肺结核患者耐多药结核病的耐药率分布。采用Ziehl-Neelsen (ZN)技术对持续咳嗽2周以上的患者进行痰液中抗酸杆菌(AFB)的筛选,共招募了103例抗酸杆菌阳性患者的痰液样本。阳性痰样本进行Xpert MTB/RIF检测(GeneXpert®,Cepheid USA),并在Lowestein Jensen培养基上37°C培养42天。采用硝酸还原法(NRA)对分离菌株进行药敏试验。Xpert MTB/RIF法在83份(80.6%)样本中检出MTB,其中45份(67.2%)对利福平耐药。67株(80.7%)对至少一种一线药物耐药。对1、2、3、4种药物的耐药率分别为19.4%、35.8%、22.4%和22.4%。异烟肼耐药率最高(57.8%),乙胺丁醇耐药率最低(34.9%),耐药菌株中有30株(44.8%)为耐多药。吸烟(P=.002)、性别(P=.002)和结核病治疗史(P=.012)与耐药显著相关。受教育程度与耐多药结核病显著相关(P= 0.020)。诺思医院和圣帕特里克医院的耐多药结核病发病率分别为38.9%和46.9%。这项研究的结果表明,在研究地点的肺结核患者中耐多药结核病的患病率很高,这对充分控制结核病构成了威胁。建议及时诊断结核病,患者充分遵守治疗并提高认识和大众教育。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Resistance Rate Distribution of MDR-TB Among Pulmonary Tuberculosis Patients Attending NAUTH and St Patrick’s Hospital Mile 4 Abakiliki in Southeast Nigeria
Tuberculosis, one of the oldest recorded human afflictions, is still one of the biggest killers among the infectious diseases, despite the worldwide use of a live attenuated vaccine and several antibiotics. This study was designed to assess the resistance rate distribution of MDR-TB among pulmonary tuberculosis patients attending Nnamdi Azikiewe University Teaching Hospital (NAUTH) Nnewi and St Patrick’s Hospital Mile 4 Abakaliki in the Southeast Nigeria. Patients with persistent cough for over two weeks were screened by Ziehl-Neelsen (ZN) technique for the presence of acid fast bacilli (AFB) in their sputum and a total of 103 patients with AFB positive sputum samples were recruited. The positive sputum samples were subjected to Xpert MTB/RIF assay (GeneXpert®, Cepheid USA) and culture on Lowestein Jensen medium for 42 days at 37°C. Drug susceptibility testing was done on the isolates using the nitrate reduction assay (NRA). Xpert MTB/RIF assay detected MTB in 83 (80.6%) samples out of which 45 (67.2%) were rifampicin resistant. Sixty-seven (80.7%) of the isolates were resistant to at least one of the first-line drugs. Primary resistance was 91% while 19.4%, 35.8%, 22.4% and 22.4% of the isolates were resistant to one, two, three and four drugs respectively. Isoniazid had the highest rate of resistance (57.8%) while Ethambutol had the least (34.9%) and 30 (44.8%) of the resistant isolates were MDR. Smoking (P=.002), gender (P=.002) and history of TB treatment (P=.012) were significantly associated with drug resistance. Educational status was significantly associated with MDR-TB (P=.020). NAUTH and St Patrick’s hospital had MDR-TB rates of 38.9% and 46.9% respectively. The findings of this study indicate high prevalence of MDR-TB among patients with pulmonary TB in the study sites and this portrays a menace to adequate TB control. Prompt diagnosis of TB, adequate patient compliance to therapy and increased awareness and mass education is recommended.
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来源期刊
Annual review of chemical and biomolecular engineering
Annual review of chemical and biomolecular engineering CHEMISTRY, APPLIED-ENGINEERING, CHEMICAL
CiteScore
16.00
自引率
0.00%
发文量
25
期刊介绍: The Annual Review of Chemical and Biomolecular Engineering aims to provide a perspective on the broad field of chemical (and related) engineering. The journal draws from disciplines as diverse as biology, physics, and engineering, with development of chemical products and processes as the unifying theme.
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