Abstract:We aimed to evaluate the drug-resistance and efficacy of anti-tuberculosis treatment (ATT) in young initiative pulmonary tuberculosis (PTB) patients in Wuhu. The 172 initiative type-3 PTB cases under 26 yrs in Wuhu during 2010 and 2015, were obtained short-term ATT and followed up for 2 yrs. Chi-squared test and Fisher’s Exact test were used to analyze the cessation rates of two career groups and post-year relapse rates of two groups with different curative standards, respectively. In the 172 cases, bacteria positive rate was 33.7%, the total drug-resistant(DR) and multi-drug resistant (MDR) rates were 25.9% and 3.4%, respectively. The DR rates to isoniazid, streptomycin, rifampicin and ethambutol were 17.2%, 13.8%, 3.4% and 3.4%, respectively. In 10 cases with irregular medication, the percentage of poor patient adherence was 60%. The cessation rate of unemployed (10.3%) was much higher than that of other careers (2.1%) and the difference had statistical significance by Chi-squared test (χ2=6.853,P<0.01). Six unemployed patients with ATT recovered and the post-year relapse rate was 33.3%, while the other four failed, of which the MDR rate was 50%. In 162 cases with full course of ATT, 115 got X-ray cure, 29 just got clinical cure, and the post-year relapse rates of such two groups had no statistical difference by Fisher’s Exact test (P>0.05). In 18 cases failing in the initiative ATT, 10 still failed after retreatments, of whom the initiative drug-resistant (IDR) rate was 20% and the acquired one was 50%. The IDR of young PTB in Wuhu was not optimistic. IDR mainly to isoniazid and irregular medication attributed to most failure of ATT, induced further DR and PTB relapse. For most young initiative PTB, good therapeutic efficacy could be achieved with short-term ATT, which could end after reaching the clinical curative standard. More attention should be given to initiative PTB cases of IDR, and more propaganda of PTB prevention and control should be given to high risky young groups like unemployed population.
孙健, 杨剑, 杨进孙, 杨江华. 172例年轻初治Ⅲ型肺结核耐药状况和抗痨效果调查分析[J]. 中国人兽共患病学报, 2018, 34(11): 1059-1062.
SUN Jian, YANG Jian, YANG Jin-sun, YANG Jiang-hua. Drug-resistance in 172 initiative cases of young type-3 pulmonary tuberculosis patients. Chinese Journal of Zoonoses, 2018, 34(11): 1059-1062.