Resistance of Mycobacterium tuberculosis to Four First-line Anti-tuberculosis Drugs in a Referral Hospital in Northern Taiwan, 2002-2006

北臺灣某後送醫院之四種第一線抗結核藥物抗藥性研究，2002-2006

林賢君(Shian-Jiun Lin) ； 余芳蘭(Fang-Lan Yu) ； 李兆清(Jau-Ching Lee) ； 白冠壬(Kuan-Jen Bai) ； 李俊年(Chun-Nin Lee) ； 許翰琳(Han-Lin Hsu) ； 余明治(Ming-Chih Yu)

《胸腔醫學》 23卷5期 (2008/10) Pp. 316-324

https://doi.org/10.29806/TM.200810.0001

摘要

前言：探討2002至2006年，台北醫學大學萬芳醫院的結核菌對第一線抗結核菌藥物（isoniazid、 rifampin、ethambutol及streptomycin）抗藥性情況。
方法：以回溯性方法來調查。從2002年1月至2006年12月，436株接受藥物敏感試驗之結核菌株被分析。藥物敏感試驗使用間接瓊脂比例法(indirect agar proportion method)。
結果：436株結核菌株中，343株來自於新病人，93株來自於曾經治療過的病人。全部菌株中，至少對一種抗結核菌藥物具抗藥性的比率為17.6%。新病人與曾經治療過病人中，至少對一種抗結核菌藥物具抗藥性的比率分別為11.7%與39.8%。全部菌株中，對個別抗結核菌藥物具抗藥性的比率分別為：isoniazid 12.4%、rifampin 7.1%、ethambutol 3.2%、streptomycin 9.2%。多重抗藥性（至少對isoniazid與rifampin具抗藥性）發生於全部病人、新病人、曾經治療過病人的比率分別為：5.7%、1.5%、21.5%。
結論：在臺灣，抗藥性的存在對治療結核病仍然是一嚴重問題。因此，在治療結核病時，特別對曾經使用過藥物的病人，應該要考慮到抗藥性問題。

關鍵字

抗藥性 ； 結核菌

並列摘要

Introduction: The purpose of this retrospective study was to investigate the drug resistance of Mycobacterium tuberculosis to 4 first-line anti-tuberculosis (TB) drugs (isoniazid (INH), rifampin (RIF), ethambutol (EMB), streptomycin (SM)) at Taipei Medical University-Wan Fang Hospital from 2002 to 2006.
Methods: From 1 January 2002 through 31 December 2006, drug susceptibility testing for first-line anti-TB drugs, including INH, RIF, EMB, and SM, was performed using the indirect agar proportion method. A retrospective review of medical records to define the drug resistance of new, previously treated, and combined cases was conducted.
Results: Of the 436 M. tuberculosis isolates, 343 were recovered from new cases and 93 from previously treated cases. The combined drug resistance rate to at least 1 drug was 17.6%. The drug resistance rate to at least 1 drug among new cases was 11.7% and among previously treated cases was 39.8%. The combined drug resistance rate to individual drugs was 12.4% to INH, 7.1% to RIF, 3.2% to EMB, and 9.2% to SM. The rates of combined multidrug resistance (resistance to at least INH and RIF), among new cases, and previously treated cases were 5.7%, 1.5%, and 21.5%, respectively.
Conclusions: Drug resistance remains a serious problem in the treatment of TB in Taiwan. When treating a TB patient, drug resistance should be considered, especially in previously treated cases.

並列關鍵字

drug resistance ； Mycobacterium tuberculosis