期刊
TROPICAL MEDICINE & INTERNATIONAL HEALTH
卷 15, 期 10, 页码 1179-1184出版社
WILEY
DOI: 10.1111/j.1365-3156.2010.02590.x
关键词
extensively drug-resistant; tuberculosis; health worker
资金
- South African National Research Foundation
- South African Medical Research Council
- EU
- EDCTP
- Europe-AID
- UK-MRC
- NIHR UCL-HNHSTrust CBRC
- South African MRC and Center for Disease Control through MRC
- Emory School of Medicine
OBJECTIVE To determine the clinical profile and outcomes of health care workers (HCWs) with extensively drug resistant tuberculosis (XDR-TB) in the Eastern and Western Cape Provinces of South Africa. METHOD Retrospective case record review of 334 patients with XDR-TB reported during the period 1996-2008 from Western and Eastern Cape Province, Cape Town, South Africa. Case records of HCWs with XDR-TB were analysed for clinical and microbiological features, and treatment outcomes. RESULTS From 334 case records of patients with XDR-TB, 10 HCWs were identified. Eight of ten were HIV-uninfected, and four of 10 had died of XDR-TB despite treatment. All 10 HCWs had received an average of 2.4 courses of TB treatment before being diagnosed as XDR-TB. CONCLUSIONS In the Eastern and Western Cape provinces of South Africa XDR-TB affects HCWs, is diagnosed rather late, does not appear to be related to HIV status and carries a high mortality. There is an urgent need for the South African government to implement WHO infection control recommendations and make available rapid drug susceptibility testing for HCWs with suspected multidrug-resistant (MDR)/XDR-TB. Further studies to establish the actual risk and sources of infection (nosocomial or community) are required.
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