结核分枝杆菌的耐药性

Saad Jamal
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摘要

COVID-19大流行也对全球传染病的发现和管理产生了重大影响。由于医疗资源难以应对大流行,人们普遍担心其他感染和非传染性疾病会增加。结核病分枝杆菌仍然是世界上死亡率和发病率最高的原因之一,2019年有1000万新发病例、140万死亡病例和近50万耐药结核病病例。当务之急是防止结核病耐药性的上升。耐药性的上升可主要归因于未能坚持治疗方案。最近的研究表明,细菌暴露于亚致死水平的细菌抗生素,促进细胞突变,导致增加的突变促进耐药性。由于与耐药结核病的检测和治疗相关的问题,我们的目标是对药物敏感结核病病例实施严格的一级和二级预防措施,以防止耐药性的上升,这是至关重要的。在讨论一级和二级预防措施时,必须强调直接督导下短程化疗的重要性。多学科卫生小组和辅助卫生工作者参与监测受影响患者的治疗,这一点再怎么强调也不为过,因为这是防止治疗失败的最简单和有效的方法。此外,耐多药结核病的治疗费用仍然超出了社会中低收入阶层的承受能力。降低药物成本以及提供方便和负担得起的快速调查以发现耐药性是当务之急
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Drug resistance In Mycobacterium Tuberculosis
The COVID-19 pandemic has also had a significant impact on the detection and management of infectious diseases worldwide. As the healthcare resources struggle to deal with the pandemic, there is widespread fear that there will be a rise in other infections and non-communicable diseases. Mycobacterium Tuberculosis remains one of the highest cause of mortality and morbidity in the world with 10 million new cases, 1.4 million deaths and nearly half a million cases of drug-resistant TB, in 2019. The need of the hour is to prevent the rise of drug resistance in TB. The rise in drug resistance can be mainly attributed to failure to adhere to treatment regimens. Recent studies show that the exposure of bacteria to sublethal levels of bacterial antibiotics, promotes cellular mutations, leading to increased mutations promoting drug resistance. Because of the problems associated with the detection and treatment of drug-resistant tuberculosis, it is of paramount importance that we aim to implement stringent measures of primary and secondary prevention against cases of drug-sensitive tuberculosis to prevent the rise of drug resistance. It is important to highlight the importance of DOTS while talking about measures of primary and secondary prevention. The involvement of the multidisciplinary health team and auxiliary health workers to monitor the treatment of affected patients cannot be stressed enough, since this is the most simple and effective way to prevent treatment failure. Furthermore, the cost of treatment of MDR-TB remains out of reach of the middle and lower middle-income strata of society. It is the need of the hour to lower the cost of drugs as well as provide easy and affordable access to rapid investigations to detect drug resistance
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