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地点:实施国家结核病控制规划的韩国245个卫生中心及韩国国家结核病协会的结核实验室网络。目的:观察韩国1994-2004年间抗结核药物的耐药趋势和可能的相关因素。设计:评估在给定的时期内,在卫生中心登记治疗的所有结核病人。结果:2004年监测发现的2 636名新涂阳病人中,338例(12.8%,95%可信区间[CI]11.5-14.1)显示对任一一种一线抗结核药物耐药:261例耐异烟肼(INH) (9.9%,95%CI8.8-11.0)。71例为耐多药(MDR)(2.7%,95%CI2.1-3.3)。与先前的监测相比,自1994年以来,新病例中耐药有统计学显著增高的有MDR(P=0.006 75)、任一药物耐药(P=0.03779)、INH耐药(P=0.00313)、利福平耐药(P=0.001 76)。新病例中,对任意一个二线药物耐药介于0.1%(卷曲霉素)和1.1%(对氨基水杨酸)之间,复治病例中,对任意一个二线药物耐药介于1.1%至3.6%之间。新病例和复治病例中,对卡那霉素和氧氟沙星的耐药率分别为1.4%和2.6%。结论:新病例中耐药具有统计学显著增加。
Location: South Korea’s 245 health centers implementing the national tuberculosis control program and the tuberculosis laboratory network of the Korea National Tuberculosis Association. OBJECTIVE: To observe the trend of drug resistance and possible related factors of anti-TB drugs in South Korea during 1994-2004. Design: Assess all TB patients enrolled in health centers for a given period of time. RESULTS: Of the 2,636 new smear-positive patients monitored in 2004, 338 (12.8%, 95% confidence interval [CI] 11.5-14.1) showed resistance to any of the first-line anti-TB drugs: 261 patients Isoniazid (INH) (9.9%, 95% CI 8.8-11.0). 71 were MDR (2.7%, 95% CI 2.1-3.3). There was a statistically significant increase in resistance to MDR among new cases since 1994 (P = 0.00675), resistance to either drug (P = 0.03779), INH resistance (P = 0.00313 ), Rifampicin resistant (P = 0.001 76). Of the new cases, resistance to any of the second-line agents was between 0.1% (capreomycin) and 1.1% (paracetamol), and for any second-line drug, the relapse rate was between 1.1% and 3.6% between. Among new cases and retreatment cases, the resistance rates to kanamycin and ofloxacin were 1.4% and 2.6% respectively. Conclusions: There is a statistically significant increase in resistance in new cases.