摘要
结核分枝杆菌(mtb)的耐药性是一个日益严重的全球性问题。由于没有德国城市人群的公共卫生数据,我们调查了过去7年我们的住院患者(n = 1011)的耐药性。因此,我们评估了异烟肼、链霉素、利福平、吡嗪酰胺、丙硫酰胺和乙胺丁醇的临床资料和药敏试验结果(断点技术/比例法)。1987年以来,单药耐药(SDR)发生率相对稳定在5.9%(3.9% ~ 7.8%),但多药耐药(>或= 2一线药物)发生率从1987年的1.7%上升到1993年的5.8%。69%的耐多药菌株患者对两种药物有耐药性,31%对三种或三种以上的药物有耐药性。特别提款权和耐多药结核病的危险因素显示以前的治疗(优势比(OR)(95%置信区间(95% CI));特别提款权2.2 (1.7 - -4.0);MDR 4.5 (2.3 - -8.8));以及外国出生身份(特别提款权2.2 (1.3-3.6);MDR 3.5(1.8-6.8)是与耐药相关的最重要因素。 Both primary and acquired resistance were higher in foreign-born than in German-born patients. We conclude that there was a considerable increase in multidrug-resistant tuberculosis in our hospital from 1987 to 1993. Since previously treated patients and patients born in countries with a high level of primary resistance had an increased risk of drug-resistant tuberculosis, we would advise a four drug regimen as initial therapy in those patients.