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Objective To evaluate the efficacy and safety of short-term treatment including fluoroquinolones anti-tuberculosis drugs for rifampicin resistant pulmonary tuberculosis(TB)in those areas carrying out the 'TB control project'.Methods TB cases involved in this study were from TB drug resistance surveillance in Heilongiiang province,Zhejiang province and Shenzhen city from 2004 to 2006.TB cases with rifampicin resistant were randomly divided into the treatment group(including fluoroquinolones anti-tuberculosis drugs group)and the control group(re-treatment regimen group).The treatment group was treated wim 3RFT AM ofx Pto PAS-INH/5RFT ofx Pto PAS.INH while the control group was treated with 3 H3R323E3S3/5 H3R3E3.Efficacy of short-term treatment was analyzed by per-protocol analysis(PP analysis)and intention-to-treat analysis(ITT analysis)while drug adverse reactions was also observed.Results (1)154 patients with rifampicin resistant pulmonary tuberculosis were recruited among them,25(16.2%)were only resistant to rifampicin,114(74.0%)to MDR-TB and 15(9.8%)to others(resistant R+S,resistant R+E and resistant R+E+S).114 TB cases completed the fuIl course of treatment,with 71 in the treatment group and 43 in the control group.(2)Sputum negative conversion rate of the treatment group and the control group were 78.9%and 65.1%(X2CMH=4.558,P=0.011)respectively,by per-protocol analysis.Sputum negative conversion rate of the treatment group and the control group were 65.9%and 40.6%(X2CMH=0.272,P=0.001)respectively,by intention-to-treat analysis.The sputum negative conversion rate of the treatment group was higher than in the control group when treating rifampicm resistant pulmonary tuberculosis and MDR-TB patients.(3)Three patients withdrew in each of the two groups because ofadverse effects to the drugs.Rates of adverse reaction to drugs appeared to be 23.9%(17/71)and 18.6%(8/43)in the treatment and in the control groups,with no statistically significant difference between the two groups.Conclusion The efficacy of treatment including fluoroquinolones anti-tuberculosis drugs group seemed beaer than the re-treatment regimen group in treating patients with rifampicin resistant pulmonary tuberculosis and those MDR-TB patients.
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<p><b>OBJECTIVE</b>To explore the influences of intervention on the abilities of detecting pulmonary tuberculosis cases in general hospitals.</p><p><b>METHODS</b>We selected 6 general hospitals at 3 different levels (A, B, and C). The intervened group included hospitals A1, B1, and C1, and the non-intervened group included hospitals A2, B2, and C2. The results after intervention were compared.</p><p><b>RESULTS</b>The report rate of pulmonary tuberculosis, sputum positive rate of reported cases, and sputum check rate of reported cases were significantly higher in hospital A1 than grouping hospital A2 (P = 0.000, P = 0.045, and P = 0.017, respectively). The report rate and sputum examination rate of reported cases were significantly higher in hospital B1 than grouping hospital B2 (P = 0.000, P = 0.024, respectively). The report rate and sputum examination rate of reported cases were significantly lower in hospital C1 than grouping hospital C2 (P = 0.000, P = 0.001, respectively). In hospital A1, the report rate, sputum positive rate of reported cases, and sputum check rate of reported cases were not significantly different before and after intervention (P = 0.182, P = 0.116, and P = 0.583, respectively). In hospital B1, the report rate were significantly different before and after intervention (P = 0.004), while the sputum positive rate of reported cases and sputum check rate of reported cases were not significantly different (P = 0.909, P = 0.052, respectively). In hospital C1, the report rate was significantly higher after intervention (P = 0.025). In hospital C2, the sputum check rate significantly increased (P = 0.000).</p><p><b>CONCLUSIONS</b>Intervention influences the hospitals abilities to detect pulmonary tuberculosis cases. However, more optimized and long-term intervention mechanism should be established to increase case detection rate of pulmonary tuberculosis.</p>
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Humans , Hospitals, General , Sputum , Microbiology , Tuberculosis, Pulmonary , DiagnosisABSTRACT
<p><b>OBJECTIVE</b>To explore the epidemic distribution of Mycobacterium tuberculosis isolates from Beijing, Guangdong and Ningxia, and to determine M. tuberculosis strains of the "Beijing Family".</p><p><b>METHODS</b>Two hundred and six IS6110 DNA fingerprinting patterns of M. tuberculosis strains from three provinces (city) were transferred to digital data, compared with the world M. tuberculosis DNA fingerprinting database, and then clustered by Gel compare 4.1 software. The clustering values in different patients with tuberculosis were compared by chi(2) test. Risk factors for recent transmission were calculated using odd ratios.</p><p><b>RESULTS</b>No M. tuberculosis strains were found the same as those of DNA fingerprint database. 56.8% (117/206) fingerprinting patterns of M. tuberculosis shared by least two-thirds of the IS6110 fragments and their Spoligotyping fingerprinting patterns were consistent with those of M.tuberculosis strains of the "Beijing Family". There were significant differences between female and male, different age groups (< 42 years old) and older (>or= 42 years old) (P < 0.05). Odd ratio was 5.06 in the group younger than 42 years old (95% CI: 1.00 - 34.34) and was 4.43 (95% CI: 0.94 - 28.76) in males.</p><p><b>CONCLUSION</b>M. tuberculosis strains of "Beijing Family" were popular in Beijing, Guangdong and Ningxia. Men and younger age group (< 42) were shown to be infected by identical strains more often than women and older aged which might play an important role in the recent transmission of tuberculosis in these areas. IS6110 DNA fingerprinting of M. tuberculosis could be used to trace the source of tuberculosis infection.</p>