Abstract：Objective To understand the treatment outcomes of patients with multidrug-resistant pulmonary tuberculosis (MDR-TB) in Foshan City, and to explore the relevant factors affecting treatment outcomes. Methods One hundred and ninety-three patients with MDR-TB in Foshan City from 2008 to 2019 were collected through the China Disease Prevention and Control Information System. Logistic regression analysis was used to retrospectivelyidentify factors affecting treatment outcomes of the patients with MDR-TB. Results Among the 193 patients, 137 (70.98%) were males and 56 (29.02%) females. The age ranged from 19 to 92 years. As for treatment outcomes, 119 cases were successfully treated, and the success rate of treatment was 61.66%. Multivariate logistic regression analysis revealed that age ≥ 60 years old (OR=4.111, 95%CI:1.686-10.025), lean population (OR=2.072, 95%CI:1.112-3.883), having no a negative result of sputum culture test after a 6-month treatment (OR=3.332, 95%CI:1.742-6.332), retreatment patients (OR=3.772, 95%CI:1.394-10.191), using second-line anti-TB drugs (OR=4.492, 95%CI:2.092-9.663), and ofloxacin resistance (OR=6.598, 95%CI:2.612-16.603) were risk factors affecting the success of MDR-TB treatment. Conclusion It is necessary to formulate a therapeutic regimen based on the drug sensitivity results for the patients with MDR-TB, and special attention should be paid to the rationality of the regimen for patients without a negative result of sputum culture test after a 6-month treatment. Monitoring and management of patients aged ≥ 60 years and retreatment patients should be enhanced, and the successful rate of treatment of the MDR-TB patients should be further improved.
[1] Shah NS,Auld SC,Brust JC,et al. Transmission of extensively drug-resistant tuberculosis in South Africa[J]. N Engl J Med,2017,376(3):243-253. [2] 任坦坦,陆普选,邓国防,等.2020 WHO全球结核报告:全球与中国关键数据分析[J].新发传染病电子杂志,2020,5(4):280-284. [3] 刘剑君,肖和平,成诗明,等. 耐多药结核病化学治疗指南[M].北京:人民卫生出版社,2019:1-127. [4] Ali MH,Alrasheedy AA,Kibuule D,et al.Assessment of multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in Sudan; findings and implications[J]. Expert Rev Anti Infect Ther, 2019,17(11):927-937. [5] Muniyandi M, Ramachandran R. Current and developing therapies for the treatment of multi-drug resistant tuberculosis (MDR-TB) in India[J]. Expert Opin Pharmacother, 2017,18(13):1301-1309. [6] Eshetie S, Alebel A, Wagnew F, et al.Current treatment of multidrug resistant tuberculosis in Ethiopia: an aggregated and individual patients’ data analysis for outcome and effectiveness of the current regimens[J]. BMC Infect Dis, 2018,18(1):486. [7] 周银发,张山鹰,柳珍妮,等.242例耐多药结核病患者特征及治疗转归的影响因素分析[J].中国防痨杂志,2017,39(11):1218-1222. [8] 吕德良,谭卫国,张乐平,等.深圳市耐多药结核病治疗效果及影响因素分析[J].中国防痨杂,2017,39(2):184-190. [9] 高静韬, 刘宇红. 2019年世界卫生组织全球结核病报告要点解读[J].国际呼吸杂志,2020,40(3):161-166. [10] 郝晓晖,姚岚,孙华,等.老年耐多药肺结核临床特征及转归分析[J].中华结核和呼吸杂志,2014,37(3):188-191. [11] Wang L, Xia F, Li F, et al. Pulmonary resection in the treatment of multidrug-resistant tuberculosis: a case series[J].Medicine (Baltimore),2017,96(50):9109. [12] 李哲明,谭守勇,邝浩斌,等.耐多药肺结核患者既往治疗情况对治疗效果的影响[J].广东医学,2015,36(20):3169-3172. [13] Yen YF,Chuang PH,Yen MY,et al. Association of body mass index with tuberculosis mortality: a population-based follow-up study[J].Medicine(Baltimore),2016,95(1):e2300. [14] 吴郁美,刘彬彬,邓高焱,等.耐多药肺结核住院患者营养指标与营养风险筛查的相关性研究[J].实用预防医学,2020,27(12):1515-1516. [15] 崔文玉,冯丽娜,李晓红,等.210例肺结核患者营养状况调查分析[J].临床肺科杂志,2012,17(2):284-285. [16] Kurbatova EV, Cegielski JP, Lienhardt C, et al. Sputum culture conversion as a prognostic marker for end-of-treatment outcome in patients with multidrug-resistant tuberculosis: a secondary analysis of data from two observational cohort studies[J]. Lancet Respir Med,2015,3(3):201-209. [17] 李清春,陆敏,吴琍敏,等.耐多药肺结核患者治疗6个月末痰培养阴转的影响因素分析[J].中国防痨杂志,2019,41(8):869-874. [18] 吴云亮,刘晓方,张海清,等.2012—2017年徐州市结核病耐药状况分析[J].江苏预防医学,2018,29(6):662-663. [19] 李静,张阳奕,武洁,等.2007—2012年上海市结核病耐药趋势分析[J].中国防痨杂志,2014,36(1):25-30. [20] Janmeja AK, Aggarwal D, Dhillon R. Factors predicting treatment success in multi-drug resistant tuberculosis patients treated under programmatic conditions[J].Indian J Tuberc, 2018,65(2):135-139. [21] 陈海峰, 刘相, 李刚,等.氟喹诺酮类药物在耐多药肺结核病防治中的耐药情况分析[J]. 医学动物防制, 2021, 37(3):4. [22] Trebucq A, Schwoebel V, Kashongwe, et al.Treatment outcome with a short MDR－TB regimen among patients with rifampicin-resistant TB in nine African countries[J]. Int J Tuberc Lung Dis,2018,22(1):17-25.
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