氧氟沙星耐药的耐多药结核病的治疗结果和莫西沙星药敏性。
Treatment outcomes and moxifloxacin susceptibility in ofloxacin-resistant multidrug-resistant tuberculosis.
机构信息
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
出版信息
Int J Tuberc Lung Dis. 2014 Jan;18(1):39-43. doi: 10.5588/ijtld.13.0307.
SETTING
A tertiary referral centre in Seoul, South Korea.
OBJECTIVE
To investigate the effect of moxifloxacin (MFX) susceptibility and later-generation fluoroquinolone (FQ) use on the treatment outcomes of ofloxacin (OFX) resistant multidrug-resistant tuberculosis (MDR-TB).
DESIGN
Of 223 patients diagnosed with MDR-TB between January 2006 and December 2012, 70 (31.4%) patients with OFX-resistant MDR-TB were enrolled in this retrospective cohort study. Their treatment outcomes were analysed.
RESULTS
The mean age (standard deviation) of the 70 patients was 40.6 (12.9) years; 43 (61.4%) were male and 26 (37.1%) had extensively drug-resistant TB. Of the 70 patients, 22 (31.4%) had MFX-susceptible TB, while the remaining 48 (68.6%) were MFX-resistant. The MFX-susceptible and -resistant groups were comparable in terms of baseline characteristics (including age, sex and radiological severity), and respectively 90.9% (20/22) and 70.8% (34/48) were treated with later-generation FQ-containing regimens (P = 0.074; mainly MFX [40/54, 74.1%]). Treatment success was achieved in 72.7% (16/22) of the MFX-susceptible patients and in 41.7% (20/48) of the MFX-resistant patients (P = 0.021). Treatment failure was significantly higher in the MFX-resistant group (41.7% [20/48] vs. 9.1% [2/22]; P = 0.006).
CONCLUSION
Patients with OFX-resistant MDR-TB had significantly better treatment outcomes when susceptible to MFX. This probably reflects the effect of later-generation FQ treatment.
背景
韩国首尔的一家三级转诊中心。
目的
研究莫西沙星（MFX）敏感性和使用后几代氟喹诺酮（FQ）对氧氟沙星（OFX）耐药耐多药结核病（MDR-TB）治疗结果的影响。
设计
在 2006 年 1 月至 2012 年 12 月期间诊断为 MDR-TB 的 223 例患者中，70 例 OFX 耐药 MDR-TB 患者入选本回顾性队列研究。分析他们的治疗结果。
结果
70 例患者的平均年龄（标准差）为 40.6（12.9）岁；43 例（61.4%）为男性，26 例（37.1%）为广泛耐药结核病。70 例患者中，22 例（31.4%）为 MFX 敏感结核病，其余 48 例（68.6%）为 MFX 耐药。MFX 敏感组和耐药组在基线特征方面无差异（包括年龄、性别和影像学严重程度），分别有 90.9%（20/22）和 70.8%（34/48）接受了含后几代 FQ 的方案治疗（P=0.074；主要是 MFX [40/54，74.1%]）。MFX 敏感组的治疗成功率为 72.7%（16/22），MFX 耐药组为 41.7%（20/48）（P=0.021）。MFX 耐药组治疗失败率显著较高（41.7% [20/48] 比 9.1% [2/22]；P=0.006）。
结论
对 MFX 敏感的 OFX 耐药 MDR-TB 患者的治疗结果显著更好。这可能反映了后几代 FQ 治疗的效果。
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