ABSTRACT
Objective To analyze the characteristics of drug resistance in tuberculosis patients in Shaoxing and provide scientific basis for prevention and control of tuberculosis.Methods All the sputum smear -positive specimens from tuberculosis patients in Shaoxing tuberculosis designated hospitals from 2010 to June 2013 had been done by susceptibility test using susceptibility Jensen medium.The situation of drug resistance in patients with pulmonary tuberculosis was analysed.Results In the 607 sputum culture -positive cases,the total resistance rate was 20.26%;the multi -drug resistance rate was 12.85%.The resistance rate in descending order was INH,RFP,SM and EMB.In new cases,the total resistance rate was 13.09%,and the multi-drug resistance rate was 5.73%;in retreated cases,the total resistance rate was 50.00%,and the multi-drug resistance rate was 42.37%.Conclusion In Shaoxing City,the total resistance rate of tuberculosis is consistent with the national average level,but the epidemic of MDR-TB is still very serious.
ABSTRACT
<p><b>OBJECTIVE</b>To understand the clinical features of death from hand, foot and mouth disease (HFMD) and to explore the early warning index of HFMD death.</p><p><b>METHODS</b>A total of 41 HFMD death cases were collected as case group in Shandong province between 2009 and 2011, and another 123 serious HFMD cases were selected as control group according to the similar gender, place of origin and hospital level, with the ratio at 1:3. We investigated the general situation, clinical treatment, past medical history, clinical symptoms and signs of the ill children, and applied the conditional logistic regression to explore early warning index of HFMD death.</p><p><b>RESULTS</b>The rate of patients who had symptoms in nervous system, digestive system, circulatory system and respiratory system were separately 90.2% (37/41), 58.5% (24/41), 53.7% (22/41) and 90.2% (37/41) in case group; and the proportions were 44.7% (55/123), 13.8% (17/123), 10.6% (13/123) and 12.2% (15/123) respectively in control group. The difference between the two groups showed statistical significance (χ(2) = 25.881, 32.791, 34.011, 86.505, P < 0.05). In case group, 37 patients had neurogenic pulmonary edema, 26 patients got encephalitis, 15 patients had respiratory and circulatory failure, 7 patients got pulmonary hemorrhage, 4 patients had multiple organ failure, 4 patients got myocarditis and 1 patient had cerebral hernia. According to multi-factor logistic regression analysis, the early warning indicators of HFMD death included neck resistance (case group: 34.1% (14/41), control group: 4.1% (5/123); OR = 7.145, 95%CI: 1.748 - 29.204), vomiting (case group: 58.5% (24/41), control group: 13.8% (17/123); OR = 5.632, 95%CI: 1.793 - 17.685) and increase of heart rate (case group: 53.7% (22/41), control group: 10.6% (14/123), OR = 6.370, 95%CI: 1.517 - 26.743).</p><p><b>CONCLUSION</b>In the process of clinical treatment and care, we should interfere the serious HFMD patients with neck resistance, vomiting and increase of heart rate, and thereby reduce the death from HFMD.</p>