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背景:加拿大Alberta省结核病机构。目的:估计结核分支杆菌对抗结核药物的耐药率与既往治疗、出生国家、年龄和在加拿大居住时间的关系。设计:1982-1994年间Alberta移民中全部培养阳性诊断的结核病的回顾性图表评价。结果:总共753名培养阳性移民结核病人进行了研究,131名病人(17.4％,95％可信限[CI]14.7,20.1)的菌株对一个或更多一线药物(异烟肼[INH]、利福平[RIF]、乙胺丁醇[EMB]、吡嗪酰胺[PZA]和链霉素[SM]有耐药,初始和继发耐药率分别是16.4％和30.3％,(P=0.003,优势比[OR]2.2,95％CI1.3,3.8),40岁及以下病人的耐药发生率为22.2％,40岁以上病人为13.8％(P=0.005,OR1.8,95％CI 1.2,2.6)。在加拿大生活不到15年的病人20.4％分离出耐药结核分支杆菌,在诊断前移民到加拿大已15年以上的病人是9.0％。(P<0.001;OR2.4,95％CI 1.3,4.2)在所有移民病人中对各个药的耐药率如下:INH9.9％(95％CI7.8,12.0),RIF0.8％(95％CI 0.2,1.4),EMB1.9％(95％CI 1.0,2.8),PZA 1.9％(95％CI0.3,3.5)和SM12.9％(95％CI 10.4,15.4),来自越南、中国和菲律宾移民病人中含耐一个或更多一线药物的病例分别为30.2％,21.8％和15.5％(P=0.04)。结论:在诸如加拿大这样工业化国家中大多数诊断的结核病例是国外出生的,连续的药物耐药性调?
Background: The Tuberculosis Unit in Alberta, Canada. PURPOSE: To estimate the relationship between the rate of resistance to tuberculosis in Mycobacterium tuberculosis and past treatment, country of birth, age, and length of stay in Canada. Design: A retrospective chart review of all cultures positive for TB in Alberta immigrants between 1982 and 1994. RESULTS: A total of 753 patients with positive immigrant tuberculosis were studied, and 131 patients (17.4%, 95% confidence limits [CI] 14.7, 20.1) were tested against one or more first-line drugs (INH, Rif], ethambutol [EMB], pyrazinamide [PZA] and streptomycin [SM] were resistant with initial and secondary drug resistance rates of 16.4% and 30.3%, respectively 0.003, odds ratio [OR] 2.2,95% CI 1.3, 3.8). The rate of resistance in patients 40 years of age and younger was 22.2% and in patients over 40 years of age was 13.8% (P = 0.005, OR1.8,95% CI 1.2, 2.6). Of the 20.4% of patients who lived less than 15 years in Canada, M. tuberculosis was isolated and 9.0% of patients migrated to Canada more than 15 years prior to diagnosis (P <0.001; OR 2.4, 95% CI 1.3, 4.2) The resistance rate to each drug among all immigrant patients was as follows: INH 9.9% (95% CI 7.8, 12.0), RIF 0.8% (95% CI 0.2, 1.4), EMB1. 9% (95% CI 1.0, 2.8), PZA 1.9% (95% CI 0.3, 3.5) and SM 12.9% (95% CI 10.4, 15.4) More first-line medications were reported at 30.2%, 21.8% and 15.5%, respectively (P = 0.04). Conclusions: In industrialized countries such as Canada Most TB cases diagnosed home is foreign-born, continuous drug resistance tune?