OBJECTIVE: To determine acquired drug resistance among failure and relapse cases after treatment of new smear-positive tuberculosis. METHODS: A cohort of 2901 patients with new smear-positive tuberculosis was enrolled in Vietnam. Sputum samples were stored at enrolment. Upon failure or relapse, another sputum sample was collected. Both were cultured and underwent drug susceptibility testing and restriction fragment length polymorphism (RFLP) typing. RESULTS: Of 40 failure cases, 17 had multidrug resistance (MDR) at enrolment. At failure, 15 of the 23 (65%) patients without primary MDR had acquired MDR. Of 39 relapse cases and 143 controls, none had primary MDR. CONCLUSION: Primary drug resistance was a strong risk factor for failure and relapse and for acquiring further resistance. As 80% of failure cases had MDR, the standard re-treatment regimen appears inadequate for failure cases in this control programme with a very high cure rate among new cases.
OBJECTIVE: To determine acquired drug resistance among failure and relapse cases after treatment of new smear-positive tuberculosis. METHODS: A cohort of 2901 patients with new smear-positive tuberculosis was enrolled in Vietnam. Sputum samples were stored at enrolment. Upon failure or relapse, another sputum sample was collected. Both were cultured and underwent drug susceptibility testing and restriction fragment length polymorphism (RFLP) typing. RESULTS: Of 40 failure cases, 17 had multidrug resistance (MDR) at enrolment. At failure, 15 of the 23 (65%) patients without primary MDR had acquired MDR. Of 39 relapse cases and 143 controls, none had primary MDR. CONCLUSION: Primary drug resistance was a strong risk factor for failure and relapse and for acquiring further resistance. As 80% of failure cases had MDR, the standard re-treatment regimen appears inadequate for failure cases in this control programme with a very high cure rate among new cases.
Authors: Paul H C Eilers; Dick Van Soolingen; Nguyen Thi Ngoc Lan; Rob M Warren; Martien W Borgdorff Journal: J Clin Microbiol Date: 2004-06 Impact factor: 5.948
Authors: Xianqin Ai; Ke Men; Liujia Guo; Tianhua Zhang; Yan Zhao; Xiaolu Sun; Hongwei Zhang; Guangxue He; Marieke J van der Werf; Susan van den Hof Journal: BMC Public Health Date: 2010-03-07 Impact factor: 3.295
Authors: Dick Menzies; Andrea Benedetti; Anita Paydar; Sarah Royce; Pai Madhukar; William Burman; Andrew Vernon; Christian Lienhardt Journal: PLoS Med Date: 2009-09 Impact factor: 11.069