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背景:一个不住院的美沙酮治疗规程(MTP), 目的:调查MTP中耐多药结核病(MDR-TB)的传播。 设计:病例确定为从1994年1月1日到1996年1月1日在MTP中成员或者工作人员发生的结核病。至少一次结核分支杆菌培养阳性并耐异烟肼和利福平。进行接触者的确认、寻找和评价。 结果:在462名成员和工作人员中有13例发生MDR-TB_c一个人类免疫缺陷病毒(HIV)感染咨询组的五分之一成员(6/30)成为MDR-TB_o已知HIV阳性的病人比HIV阴性的病人有更大的患结核病危险性(RR 5.2,95％ CI 1.2-22.7)。449名成员和工作人员确定为接触者,找到并筛检了393人(87.5％)。在那些以前结核茵素皮试阴性者中,18.5％(56/303)皮试阳转。当传染期的传染性病例参加MTP时会增加阳转的危险性(RR2.5,95％CI1.1-6.0)。 结论:在一个不住院MTP中众多HIV感染成员发生MDR-TB的广泛传播。这个暴发强调在此环境中制定行之有效的预防结核病传播策略的重要性。
Background: An out-of-hospital methadone treatment protocol (MTP), Purpose: To investigate the spread of multidrug-resistant tuberculosis (MDR-TB) in MTP. Design: Case identified as tuberculosis occurring in MTP members or staff from January 1, 1994 to January 1, 1996. Mycobacterium tuberculosis is cultured at least once and is resistant to isoniazid and rifampicin. Confirm contacts, find and evaluate. RESULTS: One-fifth of the 462 members and staff members in one of five MDR-TB_c HIV counseling groups (6/30) developed MDR-TB_o-known HIV-positive patients HIV-negative patients have a greater risk of developing tuberculosis (RR 5.2, 95% CI 1.2-22.7). 449 members and staff were identified as contacts and 393 (87.5%) were found and screened. Of those previously negative for tuberculin skin test, 18.5% (56/303) skin test positive. When infectious cases of infectious disease participate in MTP will increase the risk of positive (RR2.5, 95% CI1.1-6.0). CONCLUSIONS: The widespread transmission of MDR-TB occurs in a large number of HIV-infected members of a non-hospital MTP. This outbreak underscores the importance of developing an effective strategy for preventing tuberculosis in this environment.