摘要
自20世纪90年代以来,全球结核病疫情回升,结核分枝杆菌耐药是其中的一个重要原因。广泛耐药结核病是指在耐多药结核病(即同时对异烟肼和利福平耐药的结核分枝杆菌引起的结核病)的基础上,还对氟喹诺酮类药物和至少3种二线静脉用抗结核药物(卷曲霉素、卡那霉素、阿米卡星)中的1种耐药的结核分枝杆菌引起的结核病。我国是结核病高流行国家,耐药结核病,尤其是耐多药结核病给我国人民经济和生活带来了严重影响,而广泛耐药结核病的出现将进一步恶化结核病疫情的控制。目前尚缺乏对该疾病高敏感度、高特异度的诊断方法,治疗困难,住院时间长,治疗成本高,且病死危险度是耐多药结核病患者的5.45倍,是结核病预防、控制的一大障碍,给全球结核病的控制带来极大挑战。
Starting in the 1990s,a global tuberculosis epidemic has risen likely due to the appearance of drug-resistant tuberculosis.First was the worldwide appearance of multidrug-resistant（MDR） tuberculosis followed by extensively drug-resistant（XDR） tuberculosis.MDR tuberculosis is caused by Mycobacterium tuberculosis that is resistant at least to isoniazid and rifampicin.XDR tuberculosis is defined as disease caused by Mycobacterium tuberculosis with resistance to at least isoniazid and rifampicin,any kinds of fluoroquinolone,and at least one of three injectable second-line drugs（amikacin,capreomycin,or kanamycin）.Typically,the treatment for XDR tuberculosis requires the use of 4 to 5 drugs for a minimum of 18-24 months.Until now,the gold standard for drug-susceptibility testing was the agar proportion method,which needs 4-6 weeks for results to be determined.Other diagnostic technologies also have their own disadvantages.The treatment for XDR tuberculosis has not been completely established.Some studies have found that XDR tuberculosis has a 5.45-fold greater mortality rate than MDR tuberculosis.Since China is one of the highest tuberculosis burden countries in the world,it is particularly threatened by XDR tuberculosis.Significant more work is needed in the area of XDR tuberculosis.
出处
《微生物与感染》
2011年第2期117-121,共5页
Journal of Microbes and Infections
关键词
结核分枝杆菌
耐药
流行病学
诊断
Mycobacterium tuberculosis
Drug resistance
Epidemiology
Diagnosis
