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【科普】抗药性肺结核：我们应如何警惕防范？
The extensive media reports about XDR TB should not cause undo concern; however, CDC guidelines should be followed.
Recent media reports concerning a passenger with extensively drug-resistant tuberculosis (XDR T who flew on two international flights have heightened the public’s concern and awareness of this disease. XDR TB is a rare type of TB that is resistant to isoniazid, rifampin, quinolones, and at least one of three second-line injectable agents (amikacin, kanamycin, and capreomycin). In the U.S., 49 other cases of XDR TB have been reported since 1993. Although little documented information is available about this most recent case, we know that the sputum samples from this individual were "smear negative" (i.e., the acid-fast bacteria stains were negative but the culture was positive), indicating that his likelihood of being contagious is low. CDC recommends TB testing for all passengers on the involved flights who sat within two rows of the infected passenger, and suggests offering TB testing to other passengers on the flights.
Comment: Tuberculosis is transmitted most efficiently by an infected individual with a pulmonary cavity and a cough. Other factors that increase the likelihood of infection are longer duration of exposure, indoor exposure, and contact with an individual who is smear positive. Although whether XDR TB is more infectious than regular TB is not clear, XDR TB is harder to treat once infection is established. The majority of TB isolates in the U.S. are sensitive to usual first-line therapies, but the percentage of resistant strains has increased in the past decade. The extensive media reports about XDR TB should not cause undo concern; however, CDC guidelines should be followed. This case provides an excellent reminder of the need for public health efforts in contact tracing, and for making every possible effort to isolate the organism in active cases so that susceptibility testing can be done. Additional information about XDR TB is available at http://www.cdc.gov/tb and http://whqlibdoc.who.int/hq/2006/WHO_HTM_TB_2006.363_eng.pdf.
— Peggy Sue Weintrub, MD
Published in Journal Watch Pediatrics and Adolescent Medicine June 20, 2007 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title：XDR TB: How Concerned Should We Be?
题目：广泛抗药性结核：我们应如何警惕防范？
Authoreggy Sue Weintrub, MD
作者：Peggy Sue Weintrub, MD
Resource：Published in Journal Watch Pediatrics and Adolescent Medicine June 20, 2007
来源：《儿童和青少年医学》网络版.2007.6.20
The extensive media reports about XDR TB should not cause undo concern; however, CDC guidelines should be followed.
被媒体大量报道的XDR TB不应引起恐慌；但是疾病控制中心的指导方针还是需要遵循的。
Recent media reports concerning a passenger with extensively drug-resistant tuberculosis (XDR T who flew on two international flights have heightened the public’s concern and awareness of this disease. XDR TB is a rare type of TB that is resistant to isoniazid, rifampin, quinolones, and at least one of three second-line injectable agents (amikacin, kanamycin, and capreomycin).
最近媒体报道了一名携带广泛抗药性结核的旅客，这名搭乘过两架国际航班的XDR T乘客提高了大众对这种疾病的关心和认识。XDR TB是一种罕见的结核类型，对异烟肼、利福平、喹诺酮耐药，而且对三种二线注射制剂的至少一种耐药(阿米卡星、卡那霉素和卷曲霉素)。
In the U.S., 49 other cases of XDR TB have been reported since 1993. Although little documented information is available about this most recent case, we know that the sputum samples from this individual were "smear negative" (i.e., the acid-fast bacteria stains were negative but the culture was positive), indicating that his likelihood of being contagious is low.
在美国，从1993年来还报道了其它49例XDR TB病例。尽管对最近的这例病例可利用的资料信息很少，但我们已知此人的痰样本"涂片阴性"(也就是说抗酸杆菌染色阴性，但痰培养结果阳性)，这提示具有传染性的可能性较低。
CDC recommends TB testing for all passengers on the involved flights who sat within two rows of the infected passenger, and suggests offering TB testing to other passengers on the flights.
CDC强烈建议有关航班中与这名感染乘客的座位位置在两排以内的所有乘客进行结核菌素试验，而且建议航班中其他乘客进行结核菌素试验。
Comment: Tuberculosis is transmitted most efficiently by an infected individual with a pulmonary cavity and a cough. Other factors that increase the likelihood of infection are longer duration of exposure, indoor exposure, and contact with an individual who is smear positive.
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作者:admin@医学,生命科学 2011-04-01 05:11
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