J Infect:中国多药耐药肺结核患者:标准二线治疗方案有多大作用?

2018-05-18 吴星 环球医学

2018年4月,发表于《J Infect》上的一项研究,考察了接受标准二线治疗方案的中国多药耐药肺结核(MDR-TB)患者的临床结局。

2018年4月,发表于《J Infect》上的一项研究,考察了接受标准二线治疗方案的中国多药耐药肺结核(MDR-TB)患者的临床结局

目的:本研究旨在回顾性分析接受标准二线治疗方案的中国MDR-TB患者的临床结局及与较差结局相关的风险因素。

方法:2008年1月~2010年12月,总共12100例临床确诊为TB的处于高风险药物耐药TB(DR-TB)的病例纳入到本研究中。6个月的强化期每月进行一次常规随访检查,18个月的继续期每两个月进行一次随访检查。

结果:基于表型药敏试验(DST)结果,证实了2322例MDR-TB患者,其中的1542例进一步接受了标准二线抗TB方案。治疗成功率为47.6%(734/1542),其中688例(44.6%)治愈,46例(3.0%)完成治疗。之前未给药患者中具有有利结局的患者比例(57.6%)比经验性给药患者(46.1%)显着性高(OR,1.58;95% CI,1.17~2.14)。此外,使用女性MDR-TB病例(52.0%)作为参考时,具有有利结局的男性MDR-TB病例比例(45.8%)显着性低(OR,1.31;95% CI,1.03~1.60)。老年患者中,具有有利结局的MDR-TB病例比例显着下降。

结论:结果证实,在中国,3年治疗期间,少于一半的接受标准二线治疗方案的患者符合成功治疗的定义。需要更多的关注处于较差临床结局高风险的MDR-TB人群,包括男性、老年和之前接受过治疗的患者。

原始出处:

Xu C, Pang Y, Li R, et al. Clinical outcome of multidrug-resistant tuberculosis patients receiving standardized second-line treatment regimen in China. J Infect. 2018 Apr;76(4):348-353. doi: 10.1016/j.jinf.2017.12.017.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1905058, encodeId=168c19050589c, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Jul 06 14:51:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254173, encodeId=92a712541e34c, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543922, encodeId=495d154392224, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316324, encodeId=9495316324ff, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Fri May 18 12:54:13 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316315, encodeId=3a843163157b, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri May 18 12:05:23 CST 2018, time=2018-05-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1905058, encodeId=168c19050589c, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Jul 06 14:51:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254173, encodeId=92a712541e34c, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543922, encodeId=495d154392224, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316324, encodeId=9495316324ff, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Fri May 18 12:54:13 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316315, encodeId=3a843163157b, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri May 18 12:05:23 CST 2018, time=2018-05-18, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1905058, encodeId=168c19050589c, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Jul 06 14:51:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254173, encodeId=92a712541e34c, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543922, encodeId=495d154392224, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316324, encodeId=9495316324ff, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Fri May 18 12:54:13 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316315, encodeId=3a843163157b, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri May 18 12:05:23 CST 2018, time=2018-05-18, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1905058, encodeId=168c19050589c, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Jul 06 14:51:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254173, encodeId=92a712541e34c, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543922, encodeId=495d154392224, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316324, encodeId=9495316324ff, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Fri May 18 12:54:13 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316315, encodeId=3a843163157b, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri May 18 12:05:23 CST 2018, time=2018-05-18, status=1, ipAttribution=)]
    2018-05-18 执着追梦

    学习.谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1905058, encodeId=168c19050589c, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Fri Jul 06 14:51:00 CST 2018, time=2018-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254173, encodeId=92a712541e34c, content=<a href='/topic/show?id=f30ae86297d' target=_blank style='color:#2F92EE;'>#结核#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78629, encryptionId=f30ae86297d, topicName=结核)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=huhuaidong387, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1543922, encodeId=495d154392224, content=<a href='/topic/show?id=02982402298' target=_blank style='color:#2F92EE;'>#二线治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24022, encryptionId=02982402298, topicName=二线治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=520213623738, createdName=ms5768352621950538, createdTime=Sun May 20 02:51:00 CST 2018, time=2018-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316324, encodeId=9495316324ff, content=学习.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhb9xDeHojCicsdRdyC3XXdGk2ib9yLypZuHN06WeW4HO8WN0GGrgEfvnTX8gsckof05GHOU5OM4Mvx/0, createdBy=9cee1982656, createdName=执着追梦, createdTime=Fri May 18 12:54:13 CST 2018, time=2018-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=316315, encodeId=3a843163157b, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Fri May 18 12:05:23 CST 2018, time=2018-05-18, status=1, ipAttribution=)]
    2018-05-18 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

相关资讯

Microbiol Immunol:MgO纳米粒子可有效抗生素耐药细菌

本研究旨在确定MgO纳米颗粒(NPs)对临床耐药细菌菌株的抗菌和抗菌膜的作用。 通过湿化学方法合成MgO纳米粒子,并进一步通过扫描电子显微镜和能量色散X射线进行表征。通过肉汤微量稀释法和琼脂扩散法测定其抗菌活性。使用Bradford法评估细胞蛋白质渗漏。使用结晶紫染色后的微量滴定板测定来确定MgO NPs对生物膜形成和已建立的生物膜的去除作用。 结果显示,MIC值介于125和500

Eur J Trauma Emerg Surg:富含血小板血浆可用于治疗多重耐药细菌感染伤口

受染伤口,如糖尿病足感染,主要是多种微生物感染所致,这些微生物对抗菌素有很高的耐药率。感染糖尿病患者的创伤成本高,发病率高,死亡率高。因此,需要支持性局部治疗选择,如富含血小板血浆(PRP)的使用。为了证明PRP的体外抗菌作用,研究人员在感染伤口如糖尿病足感染方面开展局部PRP实施的临床试验。在这项研究中,我们旨在证明PRP对耐甲氧西林金黄色葡萄球菌(MRSA)和另外三种多重耐药细菌物种的体外抗菌

硝酸酯类药物耐药,怎么办?

硝酸酯类药物是治疗冠心病心肌缺血不可或缺的得力武器。但在临床长期使用过程中,硝酸酯类药物耐药现象多见,由此带来的弊端也越来越受到临床医生的重视,认识和防止或逆转耐药是临床的重要课题。

Front Microbiol: 萘醌衍生物可用于研发新的抗结核药物

尽管结核病是一种可治愈的疾病,但由于其治疗的长期性以及其毒性作用、结核病/艾滋病合并感染以及耐药结核分枝杆菌菌株的出现使得结核病仍然是一个全球的公共卫生问题。继续开发新型抗菌药物,可以减少治疗时间并对易感和耐药菌株有效。醌类化合物是天然来源的化合物,其中萘醌类具有抗真菌、抗寄生虫和抗分支杆菌活性。因此,我们评估了六种1,4-萘醌衍生物的潜在抗分支杆菌活性。我们测定了化合物对三种结核分枝杆菌菌株的最

Microb Drug Resist:精油的协同抗菌作用或可用于多重耐药菌的治疗

本研究旨在探究几种选定的市售精油和庆大霉素在对抗产超广谱β-内酰胺酶(ESBL)和产新德里金属-β-内酰胺酶-1(NDM-1)肺炎克雷伯菌分离株之间可能产生的协同效应。 通过双盘协同试验证实了产ESBLs。在所测试的菌株中发现了blaNDM-1基因阳性的菌株。使用肺炎克雷伯菌ATCC BAA-1705 TM菌株作为对照。使用方格棋法评估9种精油的协同作用和添加剂作用:香菜,茴香,薄荷,天竺葵

Am J Trop Med Hyg:变革性研究有望终止全球很大的传染病之一:肺结核

根据2018年3月发表在《美国热带医学与卫生杂志》上的一篇文章指出,为了控制并最终消灭结核病,必须采取更密集的生物医学研究方法。在这篇文章中,美国国立卫生研究院下属的国家过敏和传染病研究所(NIAID)所长讨论了通过应用新的诊断、治疗和疫苗方法实现结核病研究现代化的必要性。