Risk Factors for Multidrug-Resistant Tuberculosis among Patients with Pulmonary Tuberculosis at the Central Chest Institute of Thailand

Abstract

There are limited data available on the risk factors for multidrug-resistant tuberculosis (MDR-TB). Therefore, we here conducted a retrospective matched case−control study among adults with pulmonary TB who received treatment at the Central Chest Institute of Thailand (CCIT) between January 2007 and December 2013, in order to determine the risk factors associated with MDR-TB among patients with pulmonary TB. We identified 145 patients with pulmonary MDR-TB (cases) and 145 patients with drug-sensitive pulmonary TB (controls). Multivariate analysis identified the independent risk factors for MDR-TB as follows: (1) ≥ 2 episodes of prior pulmonary TB (odds ratio [OR] 39.72, 95% confidence interval (95% CI) 7.86−200.66), (2) duration of illness > 60 days (OR 3.08, 95% CI 1.52−6.22), (3) sputum acid fast bacilli smear 3+ (OR 13.09, 95% CI 4.64−36.91), (4) presence of lung cavities (OR 3.82, 95% CI 1.89−7.73), and (5) presence of pleural effusion (OR 2.75, 95% CI 1.06−7.16). Prior pulmonary TB management with a non-category I regimen (P = 0.012) and having treatment failure or default as treatment outcomes (P = 0.036) were observed in a higher proportion among patients with MDR-TB. Particular characteristics of lung cavities, including the maximum diameter ≥ 30 mm (P < 0.001), the number of cavities ≥ 3 (P = 0.001), bilateral involvement (P < 0.001), and ≥ 2 lung zones involved (P = 0.001) were more commonly observed in patients with MDR-TB. In conclusion, these clinical factors and chest radiographic findings associated with MDR-TB among patients with pulmonary TB may help physicians to provide proper management of cases for prevention of the development and spread of MDR-TB in future.

Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

“…We are actively working to (1) increase the sample size of dsptb, (2) analyze and incorporate the mdrptb cases in Shenzhen Center for Chronic Disease Control into our mdrptb case pool, (3) incorporate other imaging features such as cavitary lesion and TB lesion lobular distribution etc into the prediction model. It has been suggested that multiple cavities, particularly those with thick wall, are associated with mdrptb or xdrptb (8, 15).…”

A Study of X-Ray Chest Patterns in Multidrug-Resistant Tuberculosis (Mdr-Tb) Between Hiv Reactive and Hiv Non-Reactive Patients in a Tertiary Hilly Medical Centre

“…Bilateral cavities were more predominant in both upper zones. Chuchottaworn observed that characteristics of cavities including number of cavities ≥3, the presence of cavities ≥ 2 lung zones were associated with lung multi-drug resistant-tuberculosis (MDR TB) 10 . Manikkam S et al found cavitary lesion in 31.1% 11 .…”

Risk Factors Associated With Multidrogosistent Tuberculosis in Hospital Ii Vitarte Essalud During the Period January 2010 - December 2016

“…El tiempo de enfermedad es un factor de estudió y se encontró asociado, es así que pacientes con un tiempo de enfermedad mayor a 7 semanas tuvieron 7,27 veces más posibilidades de tener tuberculosis MDR, siendo esta diferencia estadísticamente significativa (Chi cuadrado: p<0,001), resultado concordante con estudios realizados anteriormente, como el realizado por Charoen Chuchottaworn (2015), sobre ''Factores de Riesgo para la Tuberculosis Multidrogoresistente en pacientes con tuberculosis pulmonar en el Central Chest Institute of Thailand'' en donde una duración de la enfermedad mayor a 60 días presento 3,08 más posibilidades de presentar TBC MRD con un IC del 95%: (1,52-6,22)4.…”