Risk factors associated with kanamycin-resistant tuberculosis in a Beijing tuberculosis referral hospital----中国科学院微生物研究所

科研成果

论文题目:	Risk factors associated with kanamycin-resistant tuberculosis in a Beijing tuberculosis referral hospital
作者:	Yu, HT; Wang, Q; Yang, N; Li, HM; Liang, JQ; Liu, CH
联系作者:	Liu, CH
刊物名称:	JOURNAL OF MEDICAL MICROBIOLOGY
期:	7
卷:	61
页:	960-967
年份:	2012
影响因子:	2.502
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摘要:	The rapidly increasing number of multidrug-resistant tuberculosis (MDR-TB) cases worldwide underlines the necessity for the rational use of key second-line drugs such as kanamycin. In this study, we determined the prevalence of, and risk factors associated with, kanamycin-resistant tuberculosis (TB) in 309 Hospital, Beijing, China, with the aim of providing information for better case management in order to minimize further development of extensively drug-resistant TB (XDR-TB). Drug susceptibility testing results and clinical data were retrospectively analysed for hospitalized TB patients for whom such data were available in 309 Hospital for the period 1997-2009. Univariate and multivariate analyses were used to determine the risk factors associated with kanamycin-resistant TB. During 1997-2009, 553 (14.4%) of 3843 tested Mycobacterium tuberculosis isolates from hospitalized TB patients were kanamycin-resistant. The increasing trend of resistance to kanamycin was reversed since 2000. The independent risk factors associated with kanamycin-resistant TB included living in urban areas [adjusted odds ratio (OR)=1.89], being retreated for repeat cases (adjusted OR=1.60), being smear-positive for acid-fast bacilli at admission to the hospital (adjusted OR=1.39), having ofloxacin-resistant (adjusted OR=1.61) or para-aminosalicylic acid-resistant TB (adjusted OR=1.47), having MDR-TB (adjusted OR=5.10), having MDR-TB plus ofloxacin resistance (adjusted OR=4.27) and having poly-resistant TB (adjusted OR=3.94). The remaining rate of kanamycin resistance is still high despite the reversal of the increasing trend during the past decade. Surveillance of kanamycin resistance, especially among high-risk populations, should be continued to closely monitor trends so that appropriate action can be taken.