Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Abstract

The aim of this study was to investigate the incidence of primary and secondary resistance to antituberculosis drugs and the risk factors associated with the resistance in southeast Spain.Our research was based on the clinical histories of 276 patients, diagnosed as having tuberculosis by positive culture, who were tested for drug susceptibility between January 1988 and October 1994. The clinical histories were checked by two independent investigators. Drug-resistant strains were isolated from 24 patients (8.7%). Among the 239 patients without previous tuberculosis therapy, 7 (2.9%) were drug-resistant. Among the 37 patients with previous therapy, 17 (46%) were drug-resistant. Seventeen of the 276 patients (6.2%) had resistance to a single drug. Primary resistance to isoniazid was 1.7%. Previous treatment for tuberculosis (odds ratio (OR) 39.2; 95% confidence interval (95% CI) 10.2-150); hepatic cirrhosis (OR 104; 95% CI 12.8-847); and age 45 yrs and older (OR 4.80; 95% CI 1.15-20.1) were considered risk factors associated with drug-resistant tuberculosis.We conclude that primary and secondary resistance is low in the southeast of Spain and we recommend that susceptibility testing be performed on initial M. tuberculosis isolated from patients with a history of previous tuberculosis therapy, hepatic cirrhosis or more than 44 yrs of age.

Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study

“…In Nepal, levels of drug resistance are very high, with nearly 14.7% of new patients resistant to at least one drug 2 Previous treatment of tuberculosis has been consistently reported as the risk factor within various clinical conditions and populations. [4][5][6][7][8][9][10] The present study also revealed that previous treatment of tuberculosis was strongly associated with MDR TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020).According to the National Tuberculosis Programme's Nepal National Survey in 2007, MDR among new cases of TB is 2.9% and MDR among previously treated cases is at 11% thereby giving a ratio of approximately 4:1 for prevalence of MDR in these groups, 2 this pattern holds true in our study too. Lomtadze et.…”

Tuberculose multirésistante : épidémiologie et facteurs de risque

“…Les études montrent des ratios allant de 1,5 à 8 en faveur des hommes [7,[11][12][13][14][17][18][19]. [20,21].…”

“…Plusieurs auteurs ont montré que l'alcoolisme fait partie des facteurs de risque de MDR-TB [12,31]. Les éthyliques seraient généralement inobservants à leurs traitements, ce qui favorise le développement des résistances.…”

“…L'alcoolisme peut être responsable d'une cirrhose hépatique. Les études montrent que la pré-sence d'une cirrhose hépatique augmente 42 fois le risque d'atteinte de MDR-TB [12].…”

Bacterial infections in cirrhosis

“…During the disease course, higher mortality rate and more frequent side effect to anti-tuberculosis drug are expected. Because of the preexisting liver dysfunction, application of multi-drug combination regimen warrants strict surveillance [62,63].…”