摘要
在过去的十年中,没有关于前西德耐药结核病的时间进程和耐药危险因素的数据。我们回顾了汉堡附近一家医院从1984年到1993年所有结核分枝杆菌培养阳性患者的医疗记录。采用改良比例法对异烟肼、利福平、乙胺丁醇和链霉素进行药敏试验。在1055名患者中,9.6%的分离株对一种或多种药物耐药。5.8%的分离株对异烟肼或利福平耐药,1.8%对异烟肼和利福平均耐药。耐药率在研究期间无明显变化。89名来自南美、非洲或亚洲的患者中,26%的患者存在对一种或多种药物耐药的分离株,而出生在德国的799名患者中,这一比例为7.6%(优势比(or) 4.2;95%置信区间(95% CI) 2.5-7.3)。在出生在德国的患者中,101例既往抗结核药物治疗史的患者中有32%存在耐药微生物,而698例既往未治疗的患者中有4.2%存在耐药微生物(OR 10.7;95% ci 6.1-18.7)。 Resistance rates for 35 patients, who had been treated within the last 5 yrs, and for 65 patients, who had been treated more than 5 yrs ago, were 57 and 17%, respectively (OR 6.6; 95% CI 2.9-16.6). Our results suggest that there is no increase in the proportion of drug-resistant tuberculosis in our hospital, and that patients with a recent history of antituberculosis drug therapy and patients from South America, Africa, or Asia are at high risk for drug resistance.