TY - T1的结核病耐药是用欧元ope: sunny days, but clouds on the horizon? JF - European Respiratory Journal JO - Eur Respir J SP - 825 LP - 827 DO - 10.1183/09031936.00102307 VL - 30 IS - 5 AU - Schluger, N. W. Y1 - 2007/11/01 UR - //www.qdcxjkg.com/content/30/5/825.abstract N2 - Drug-resistant tuberculosis (TB) has now emerged as a public health concern of major proportions. Although drug resistance was recognised in the British Medical Research Council's landmark streptomycin trial 1, there was little evidence that widespread resistance to multiple anti-TB drugs was a significant public health concern until New York City (NY, USA) reported that nearly 12% of all its cases in 1992 were resistant to at least isoniazid (INH) and rifampicin 2. Such cases were termed multidrug resistant (MDR). Many of these cases occurred in persons infected with HIV, and there was evidence that many of the infected patients acquired the infection in hospitals or other congregate settings, including prisons 3. Mortality associated with these cases was extremely high 4. In 1998, the World Health Organization (WHO) published the results of a global survey of drug-resistant TB, conducted from 1994–1997 5. Overall, among patients with no previous treatment for TB, INH resistance had a prevalence of 7.3%, and the overall prevalence of MDR-TB was 1.4%. Among previously treated patients, the prevalence of multidrug resistance was 13%. Resistance was present in all regions of the globe, although there were particular concentrations of cases in Russia and the countries of the former Soviet Union, Asia, the Dominican Republic and Argentina. In some of these countries, MDR-TB rates exceeded 10%, even in previously untreated patients. The response to the emergence of MDR-TB was mostly focused on using the DOTS (directly observed therapy, short-course) strategy, largely as a means of preventing the emergence of new cases of MDR-TB. The DOTS strategy, the key component of WHO's global TB control efforts, seeks to assure that, in addition to the provision of medication to patients under direct observation, there is a steady and reliable availability of … ER -