Drug resistance pattern and outcome of treatment in recurrent episodes of tuberculosis

Marjani, Majid; Baghaei, Parvaneh; Tabarsi, Payam; Shamaei, M; Mansouri, Davood; Masjedi, M R; Velayati, Ali Akbar

doi:10.26719/2012.18.9.957

Cited by 13 publications

(7 citation statements)

References 8 publications

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“…Isoniazid monoresistance was associated with a higher death rate in an observational cohort of 7433 TB patients during 2000 to 2006 in Singapore ( Low et al, 2009 ). Similarly high isoniazid resistance and impact on mortality was also reported in Iran ( Marjani et al, 2012 ).…”

Section: Discussionsupporting

confidence: 66%

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

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Background:Drug resistance substantially increases tuberculosis (TB) mortality. This study aimed to describe the prevalence of mycobacterial drug resistance pattern and association of common resistance patterns with TB mortality in Thailand.Method:A retrospective cohort study was conducted using TB surveillance data. A total of 9,518 culture-confirmed, pulmonary TB patients registered from 1 October 2004 to 31 December 2008 from the Thailand TB Active Surveillance Network were included in this study. Patients were followed up until TB treatment completion or death. Mycobacterial drug resistance patterns were categorized as pan-susceptible, rifampicin resistance, isoniazid monoresistance, and ethambutol/streptomycin resistance. Drug susceptibility testing (DST) was determined by Mycobacterial Growth Indicator Tube (MGIT) liquid culture systems. Survival analysis was applied.Result:Isoniazid monoresistance was the most common pattern, while rifampicin resistance had the largest impact on mortality. Cox regression analysis showed a significantly higher risk of death among patients with rifampicin resistance (adjusted hazard ratio (aHR) 1.9, 95% confident interval (CI), 1.5-2.5) and isoniazid monoresistance (aHR 1.4, 95% CI 1.1-1.7) than those with pan-susceptible group after adjustment for age, nationality, human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status, diabetes mellitus, cavitary disease on chest x-ray, treatment observation, and province. HIV co-infection was associated with higher mortality in patients both on ART (aHR 1.9, 95% CI 1.5-2.5) and not on ART (aHR 8.1, 95% CI 6.8-9.8).Conclusion:Rifampicin resistance and isoniazid monoresistance were associated with increased TB mortality. HIV-coinfection was associated with a higher risk of death including among those taking antiretroviral therapy.

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Section: Discussionsupporting

confidence: 66%

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

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“…In a 2006 survey in Khuzestan, the rate of MDR-TB was reported as 8.7% by conventional Minimal Inhibitory Concentration (MIC) method and 6.2% by Polymerase Chain Reaction (PCR) technique [16] . A study from the National Research Institute of Tuberculosis and Lung Disease in Iran, that presented drug resistance patterns of TB from 2003 to 2008, has shown that 2% of MTB isolates from new cases were MDR [17] .…”

Section: Discussionmentioning

confidence: 99%

Drug Resistance Pattern of Mycobacterium tuberculosis Isolates From Patients Referred to TB Reference Laboratory in Ahvaz

Badie

Arshadi

Mohsenpoor

et al. 2016

Osong Public Health and Research Perspectives

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ObjectivesTuberculosis remains one of the top three infectious disease killers. The prevalence of multidrug-resistant tuberculosis (MDR-TB) has increased substantially in the past 20 years. When drug resistance is not detected, MDR-TB patients cannot access life-saving treatment; this puts their communities at risk of ongoing MDR-TB transmission. We aimed to determine the patterns of resistance to antituberculosis drugs among Mycobacterium tuberculosis isolates from Khuzestan province in Iran.MethodsA total of 850 clinical specimens from patients suspected of active TB were cultured in 2015. Drug susceptibility testing to the first line antiTB drugs for culture positive MTB was performed on Lowenstein–Jensen medium using the proportion method.ResultsOf 850 cultured specimens, 272 (32%) were culture positive for mycobacteria. Of 64 MTB isolates that were analyzed by the proportion method, 62 (96.8%) were pan-susceptible and two (3.1%) were MDR.ConclusionAn important way to prevent the emergence of MDR and XDR TB, and the principles of full implementation of the strategy is directly observed treatment, short-course (DOTS). The efficient diagnosis and timely treatment of MDR-TB patients can prevent disease transmission, reduce the risk of drug resistance developing, and avoid further lung damage.

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“…Many countries currently fall short of this ambitious target. The predictors of favourable treatment outcomes for people with MDR‐TB vary according to the context . There are few studies on MDR‐TB treatment outcomes in resource‐constrained settings and in high MDR‐TB‐burden countries .…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes in patients with multidrug‐resistant tuberculosis in north‐west Ethiopia

Alene

Viney

McBryde

et al. 2017

Tropical Med Int Health

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objective Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia.methods A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment outcomes, which were defined as death or treatment failure.results Of the 242 patients who had complete records, 131 (54%) were cured, 23 (9%) completed treatment, 31 (13%) died, four (2%) experienced treatment failure, 27 (11%) were lost to follow-up, six (2%) transferred out, and 20 (8%) were still on treatment at the time of analysis. The overall cumulative probability survival of the patients at the end of treatment (which was 24 months in duration) was 80% (95% CI: 70%, 87%). The proportion of patients with poor treatment outcomes increased over time from 6% per person-year (PY) during 2010-2012, to 12% per PY during 2013-2015. The independent predictors of time to poor treatment outcome were being anaemic [AHR = 4.2; 95% CI: 1.1, 15.9] and being a farmer [AHR = 2.2; 95% CI: 1.0, 4.9].conclusions Overall, in north-west Ethiopia, the MDR-TB treatment success rate was high. However, poor treatment outcomes have gradually increased since 2012. Being a farmer and being anaemic were associated with poor treatment outcomes. It would be beneficial to assess other risk factors that might affect treatment outcomes such as co-infection with malaria, poverty and other socio-economic and biological risk factors.

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Drug resistance pattern and outcome of treatment in recurrent episodes of tuberculosis

Cited by 13 publications

References 8 publications

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Drug Resistance Pattern of Mycobacterium tuberculosis Isolates From Patients Referred to TB Reference Laboratory in Ahvaz

Treatment outcomes in patients with multidrug‐resistant tuberculosis in north‐west Ethiopia

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