Emerg Infect Dis 2011 Oct;17 (10): 1831-8. [IF:6.859]
Multidrug-resistant tuberculosis, People's Republic of China, 2007-2009.
He GX , Wang HY , Borgdorff MW , van Soolingen D , van der Werf MJ , Liu ZM , Li XZ , Guo H , Zhao YL , Varma JK , Tostado CP , van den Hof S .
Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. heguangxue@chinatb.org
中国疾病控制和预防中心
Abstract
We conducted a case-control study to investigate risk factors for multidrug-resistant tuberculosis (MDR TB) in the People's Republic of China. Genotyping analysis was used to estimate the percentage of cases from recent transmission among 100 MDR TB case-patients hospitalized during April 2007-July 2009. Molecular subtyping of isolates showed that 41% of MDR TB strains clustered. Beijing genotype was found in 94% of the MDR TB isolates and 79% of the pan-susceptible isolates. In multivariate analysis, MDR TB was independently associated with Beijing genotype, retreatment for TB, symptoms lasting >3 months before first evaluation at the hospital, lack of health insurance, and being a farmer (vs. being a student). MDR TB was associated with Beijing genotype and lower socioeconomic status. A large percentage of MDR TB cases seemed to result from recent transmission. Early detection, effective treatment, and infection control measures for MDR TB are needed to reduce transmission.
摘要
我们实行了一个调查中国人多药耐药结核病危险因子的病例对照研究。使用基因型分析方法来估算从2007年4月到2009年7月内100例新近住院的多药耐药结核病患者的发病百分比。单个病菌的分子亚型显示41%的多药耐药结核病菌是丛生的。在94%的多药耐药结核病个体和79%易感人群个体中发现了“北京人基因型”。基于多变量分析，多药耐药结核病跟“北京人基因型”、反复的结核治疗、在初次就诊前病症持续时间超过三个月、缺乏医疗保险以及农民（相比于学生群体）有独立相关性。多药耐药结核病与“北京人基因型”以及较低的社会经济地位存在相关性。大多数的多药耐药结核病病例是由于新近传染而导致的。早起检测，有效的治疗以及控制感染的措施对于减少多药耐药结核病的扩散是必要的。
