耐药型结核病的流行

巴尔的摩——肺结核,一种最为致命的传染疾病,出现了报复性的重新流行,特别是在非洲。严重耐药型结核病(XDR-TB)是结核病中非常难治的一种,它主要袭击有史以来医疗体系的薄弱环节,特别是艾滋病的高发地区。如果不能有效控制结核病的局部爆发、开发出确诊和治疗严重耐药型结核病的武器策略和对长期改善结核病控制进行投资,我们治疗结核病的神奇药物武器最终就会化为乌有。

20世纪40年代到70年代结核病化学疗法的发明将曾几何时的“白色瘟疫”转变成了可以根治的疾病。但是从抗生素时代刚刚开始,耐药病菌的幽灵就一直困扰着结核病的治疗。15年前,耐多种药物型结核病(MDR-TB)在纽约的流行导致了人们近乎恐慌的反应,直到对公共医疗基础设施的巨额资金注入在美国扭转了结核病蔓延的趋势之后,公众对此事的关注才逐渐消失。但是,耐药问题却一直没有得到解决,而在全球范围内控制耐药型结核病的努力也没有取得应有的效果。

输入严重耐药型结核病。世界卫生组织估计2004年新增耐多种药物型结核病425,000例,其中中国、印度和俄国占比超过60%。然而真正引起全球对严重耐药生物体高度关注的还是严重耐药型结核病在南非夸祖鲁纳塔尔省艾滋病感染人群中的爆发流行。

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