https://scholars.lib.ntu.edu.tw/handle/123456789/562507
標題: | Drug resistance pattern of Mycobacterium tuberculosis in a university hospital in Taiwan, 1998-2002 | 作者: | Liaw Y.-S. PO-REN HSUEH CHONG-JEN YU Wang S.-K. PAN-CHYR YANG KWEN-TAY LUH |
公開日期: | 2004 | 卷: | 103 | 期: | 9 | 起(迄)頁: | 671-677 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background and Purpose: During 1998-2002, most specialized tuberculosis (TB) hospitals in Taiwan were closed; as a result, more TB patients are being managed in general hospital settings. This study investigated the prevalence, patterns and risk factors of drug-resistant Mycobacterium tuberculosis at a university hospital in the 5 years after decentralization of the TB administrative and clinical control infrastructure which occurred during the implementation of the national health insurance system in Taiwan. Methods: A total of 1411 initial isolates of M. tuberculosis from specimens collected during January 1998 through December 2002 were tested for drug susceptibility of first-line anti-TB drugs using the agar proportional method. Results: The numbers of newly diagnosed culture-positive TB patients increased from 139 in 1998 to 380 in 2002. The drug resistance pattern of M. tuberculosis among these isolates was as follows: 268 (19.0%) strains were resistant to isoniazid, 86 (6.1%) to rifampin, 221(15.7%) to ethambutol, 141 (10.0%) to streptomycin, and 430 (30.5%) to 1 of these 4 drugs. Multidrug resistance (MDR), i.e., resistance to at least rifampin and isoniazid, was observed in 72 isolates (5.1%). Of the 1411 patients, isolates from patients with age < 65 years had a higher multiple drug resistance rate than those from patients with age ? 65 years (57/781, 7.3% vs 15/630, 2.4%; p < 0.001). In the analysis of risk factors for MDR, patients with MDR isolates had a significantly higher incidence of previous TB history, anti-TB therapy, longer duration of symptoms, cavitary lesions in chest X-ray, and mortality. Conclusion: A dramatic increase in cases of TB among patients treated at this university hospital was seen after the decentralization of the TB control infrastructure in Taiwan. The prevalence of drug resistance in isolates from culture-positive TB patients was 30.5% and the prevalence of MDR was 5.1%. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/562507 | ISSN: | 0929-6646 | SDG/關鍵字: | ethambutol; isoniazid; rifampicin; streptomycin; tuberculostatic agent; adult; aged; antibiotic resistance; antibiotic sensitivity; article; bacterial strain; bacterium isolate; colony forming unit; controlled study; female; groups by age; human; major clinical study; male; multidrug resistance; Mycobacterium tuberculosis; nonhuman; risk assessment; risk factor; statistical analysis; statistical significance; Taiwan; tuberculosis; university hospital; drug effect; microbiology; middle aged; multidrug resistance; tuberculosis; Adult; Aged; Aged, 80 and over; Antibiotics, Antitubercular; Drug Resistance, Multiple, Bacterial; Female; Hospitals, University; Humans; Male; Middle Aged; Mycobacterium tuberculosis; Taiwan; Tuberculosis |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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