Résumé
Objective To analyze the drug resistance of Mycobacterium tuberculosis (MT) in elderly patients with recurrent pulmonary tuberculosis .Methods We collected 1 860 M T strains from elderly patients with recurrent pulmonary tuberculosis in our hospital from January 2005 to December 2013 to review the drug resistance profile of these strains .Another 300 patients with naive pulmonary tuberculosis were included as control group .Results Significant difference was found between the males and females in terms of the resistance rate to streptomycin ,rifampicin ,ethambutol ,amikacin ,capreomycin ,or ofloxacin (P＜0 .05) .Multi‐drug resistant tuberculosis (MDR‐TB) was identified in 24 .0% (357/1 489) and extensively drug‐resistant tuberculosis (XDR‐TB) in 9 .8% (146/1 489) in male patients ,which were significantly lower than the corresponding rates of 34 .2% (127/371) and 19 .7% (73/371) in the female patients (P＜0 .05) .In all the 1 860 patients with recurrent pulmonary tuberculosis , MDR‐TB and XDR‐TB accounted for 26 .0% and 11 .8% , respectively , significantly higher than the corresponding rates of 11 .3% (34/300) and 7 .0% (21/300) in the control patients with naive pulmonary tuberculosis .Single drug resistance was identified in 20 .0% (372/1 860) of the patients with recurrent tuberculosis and 41 .0% (123/300) of the control patients (P＜0 .05) .Conclusions The MT strains isolated from elderly patients with recurrent pulmonary tuberculosis show higher resistance rate ,especially in females .It is necessary to strengthen the monitoring of drug resistance in old patients with recurrent pulmonary tuberculosis .
Résumé
BACKGROUND: Recurrent pulmonary tuberculosis (TB) can be due to relapse of the original infecting strain or due to reinfection with a new strain of Mycobacterium tuberculosis. We investigated the clinical characteristics and efficacy of short-term treatment (6 months) in patients with recurrent pulmonary TB. METHODS: Twenty-nine patients with recurrent pulmonary TB were compared with control patients who received primary treatment for pulmonary TB with respect to drug sensitivity and outcomes of treatment. RESULTS: Most patients with recurrent pulmonary TB (25 cases, 86.2%) recurred more than 2 years after the completion of previous treatment. Twenty-three patients (82.1%) with recurrent pulmonary TB were sensitive to all anti-tuberculous drugs and a ratio was similar to the drug sensitivities observed in control patients. The outcomes of short-term treatment in patients with drug-sensitive TB were not significantly different between the two groups. CONCLUSION: Recurrent pulmonary TB in the study area was likely due to reinfection with new strains. Thus the short-term treatment of patients with drug-sensitive recurrent pulmonary TB may be successful.(Tuberc Respir Dis 2008;64:341-346)