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Abstract：
UNASSIGNED: Drug-resistant tuberculosis (DR-TB) is a threat to tuberculosis (TB) control. Extra-pulmonary forms of DR-TB (DR-epTB) are not well characterized. This review summarizes the clinical features, resistance patterns and treatment outcomes of DR-epTB.
UNASSIGNED: We searched EMBASE to identify studies that reported drug-resistance among extra-pulmonary TB sites. All age groups were included in this review. Studies which did not describe drug-resistance patterns at extra-pulmonary TB sites were excluded. We summarized the proportion of resistance to individual anti-TB drugs as well as multi-drug resistant (MDR), pre-extensively drug resistant (pre-XDR) and extensively drug-resistant (XDR) TB.
UNASSIGNED: Eighteen studies with a total of 10,222 patients with extra-pulmonary TB of whom 1,236 (12.0%) had DR-epTB, were included in this review. DR-epTB was mostly reported in young people aged 28 to 46 years. While TB meningitis is the most commonly studied form, adenitis is the commonest form of DR-epTB reported in 21% to 47%. Central nervous system TB (3.8% to 51.6%), pleural TB (11.3% to 25.9%), skeletal TB (9.4% to 18.1%), abdominal TB (4.3% to 6.5%), and disseminated TB (3.8%) are also encountered. The HIV co-infection rate is reported to be 5.0% to 81.3% while 2.6% to 25.4 % have diabetes mellitus. Clinical symptoms of DR-epTB are consistent with morbidity in the affected body system. Among patients with DR-epTB, the proportion of MDR TB was 5% to 53% while that for pre-XDR TB and XDR TB was 3% to 40% and 4% to 33%, respectively. Treatment success is achieved in 26% to 83% of patients with DR-epTB while death, treatment loss-to-follow up, and treatment failure occur in 2% to 76%, 7% to 15%, and 0% to 4% respectively. Patients with DR-epTB were reported to have poorer outcomes than those with pulmonary DR-TB and extra-pulmonary drug-susceptible TB.
UNASSIGNED: Clinical features of DR-epTB are similar to those observed among people with drug-susceptible EPTB but patients with DR-epTB post worse treatment outcomes.
UNASSIGNED: We searched EMBASE to identify studies that reported drug-resistance among extra-pulmonary TB sites. All age groups were included in this review. Studies which did not describe drug-resistance patterns at extra-pulmonary TB sites were excluded. We summarized the proportion of resistance to individual anti-TB drugs as well as multi-drug resistant (MDR), pre-extensively drug resistant (pre-XDR) and extensively drug-resistant (XDR) TB.
UNASSIGNED: Eighteen studies with a total of 10,222 patients with extra-pulmonary TB of whom 1,236 (12.0%) had DR-epTB, were included in this review. DR-epTB was mostly reported in young people aged 28 to 46 years. While TB meningitis is the most commonly studied form, adenitis is the commonest form of DR-epTB reported in 21% to 47%. Central nervous system TB (3.8% to 51.6%), pleural TB (11.3% to 25.9%), skeletal TB (9.4% to 18.1%), abdominal TB (4.3% to 6.5%), and disseminated TB (3.8%) are also encountered. The HIV co-infection rate is reported to be 5.0% to 81.3% while 2.6% to 25.4 % have diabetes mellitus. Clinical symptoms of DR-epTB are consistent with morbidity in the affected body system. Among patients with DR-epTB, the proportion of MDR TB was 5% to 53% while that for pre-XDR TB and XDR TB was 3% to 40% and 4% to 33%, respectively. Treatment success is achieved in 26% to 83% of patients with DR-epTB while death, treatment loss-to-follow up, and treatment failure occur in 2% to 76%, 7% to 15%, and 0% to 4% respectively. Patients with DR-epTB were reported to have poorer outcomes than those with pulmonary DR-TB and extra-pulmonary drug-susceptible TB.
UNASSIGNED: Clinical features of DR-epTB are similar to those observed among people with drug-susceptible EPTB but patients with DR-epTB post worse treatment outcomes.
摘要：
■耐药结核病（DR-TB）是结核病（TB）控制的威胁。肺外形式的DR-TB（DR-epTB）未得到很好的表征。本文就临床特点进行综述,DR-epTB的耐药模式和治疗结果。
■我们搜索了EMBASE，以确定报告肺外结核病部位耐药的研究。所有年龄组均纳入本综述。未描述肺外TB部位耐药模式的研究被排除。我们总结了对个体抗结核药物的耐药比例以及多药耐药（MDR），广泛耐药前（pre-XDR）和广泛耐药（XDR）TB。
■18项研究，共10,222例肺外结核病患者，其中1,236例（12.0%）患有DR-epTB，包括在这次审查中。DR-epTB主要在28至46岁的年轻人中报告。虽然结核性脑膜炎是最常见的研究形式，据报道，在21％至47％之间，腺瘤是最常见的DR-epTB形式。中枢神经系统结核病（3.8％至51.6％），胸膜结核（11.3%至25.9%），骨骼结核（9.4％至18.1％），腹部结核（4.3%至6.5%），和传播结核病（3.8％）也遇到。据报道，HIV合并感染率为5.0％至81.3％，而2.6％至25.4％患有糖尿病。DR-epTB的临床症状与受影响身体系统的发病率一致。在DR-epTB患者中，耐多药结核病的比例为5％至53％，而XDR前结核病和XDR结核病的比例为3％至40％和4％至33％，分别。26％至83％的DR-epTB患者在死亡时获得了治疗成功，治疗失访，治疗失败发生在2%到76%，7%到15%，分别为0%至4%。据报道，与肺DR-TB和肺外药物易感TB相比，DR-epTB患者的预后较差。
■DR-epTB的临床特征与药物敏感型EPTB患者的临床特征相似，但DR-epTB患者的治疗效果较差。
■我们搜索了EMBASE，以确定报告肺外结核病部位耐药的研究。所有年龄组均纳入本综述。未描述肺外TB部位耐药模式的研究被排除。我们总结了对个体抗结核药物的耐药比例以及多药耐药（MDR），广泛耐药前（pre-XDR）和广泛耐药（XDR）TB。
■18项研究，共10,222例肺外结核病患者，其中1,236例（12.0%）患有DR-epTB，包括在这次审查中。DR-epTB主要在28至46岁的年轻人中报告。虽然结核性脑膜炎是最常见的研究形式，据报道，在21％至47％之间，腺瘤是最常见的DR-epTB形式。中枢神经系统结核病（3.8％至51.6％），胸膜结核（11.3%至25.9%），骨骼结核（9.4％至18.1％），腹部结核（4.3%至6.5%），和传播结核病（3.8％）也遇到。据报道，HIV合并感染率为5.0％至81.3％，而2.6％至25.4％患有糖尿病。DR-epTB的临床症状与受影响身体系统的发病率一致。在DR-epTB患者中，耐多药结核病的比例为5％至53％，而XDR前结核病和XDR结核病的比例为3％至40％和4％至33％，分别。26％至83％的DR-epTB患者在死亡时获得了治疗成功，治疗失访，治疗失败发生在2%到76%，7%到15%，分别为0%至4%。据报道，与肺DR-TB和肺外药物易感TB相比，DR-epTB患者的预后较差。
■DR-epTB的临床特征与药物敏感型EPTB患者的临床特征相似，但DR-epTB患者的治疗效果较差。
