SETTING: An Argentinean reference hospital specialising in infectious diseases. OBJECTIVE: To assess the outcomes of all human immunodeficiency virus (HIV) negative multidrug-resistant tuberculosis (MDR-TB) patients referred to or diagnosed at Hospital Muñiz. DESIGN: Clinical study for the period 1996-1999, with follow-up until June 2002. RESULTS: One hundred and forty-one adult patients (52.5% female) with resistance to two to seven drugs were studied. Fifty patients (35.5%) had not been treated previously. The most frequently used second-line drugs were 5-F-quinolones, cycloserine and ethionamide in susceptibility based individually tailored three- to five-drug regimens. Hospital admission was associated with treatment success. Forty-five episodes of severe toxicity occurred. Treatment was successful in 51.8% of cases, but follow-up of 73 patients yielded 11.9% relapse. The mortality rate was 19.1% and default was 19.9%. Logistic regression analysis was statistically significant for treatment success in relation to patient admission, residence and resistance pattern. CONCLUSION: The burden of MDR-TB in this setting--prolonged infection, treatment cost and difficulties, low rates of cure and treatment adherence and high rates of fatality and relapse--can be improved by strengthening TB control programme activities and fighting against poverty and HIV/AIDS.
SETTING: An Argentinean reference hospital specialising in infectious diseases. OBJECTIVE: To assess the outcomes of all human immunodeficiency virus (HIV) negative multidrug-resistant tuberculosis (MDR-TB) patients referred to or diagnosed at Hospital Muñiz. DESIGN: Clinical study for the period 1996-1999, with follow-up until June 2002. RESULTS: One hundred and forty-one adult patients (52.5% female) with resistance to two to seven drugs were studied. Fifty patients (35.5%) had not been treated previously. The most frequently used second-line drugs were 5-F-quinolones, cycloserine and ethionamide in susceptibility based individually tailored three- to five-drug regimens. Hospital admission was associated with treatment success. Forty-five episodes of severe toxicity occurred. Treatment was successful in 51.8% of cases, but follow-up of 73 patients yielded 11.9% relapse. The mortality rate was 19.1% and default was 19.9%. Logistic regression analysis was statistically significant for treatment success in relation to patient admission, residence and resistance pattern. CONCLUSION: The burden of MDR-TB in this setting--prolonged infection, treatment cost and difficulties, low rates of cure and treatment adherence and high rates of fatality and relapse--can be improved by strengthening TB control programme activities and fighting against poverty and HIV/AIDS.
Authors: Medea Gegia; Iagor Kalandadze; Russel R Kempker; Matthew J Magee; Henry M Blumberg Journal: Int J Infect Dis Date: 2012-03-17 Impact factor: 3.623
Authors: Dennis Falzon; Neel Gandhi; Giovanni B Migliori; Giovanni Sotgiu; Helen S Cox; Timothy H Holtz; Maria-Graciela Hollm-Delgado; Salmaan Keshavjee; Kathryn DeRiemer; Rosella Centis; Lia D'Ambrosio; Christoph G Lange; Melissa Bauer; Dick Menzies Journal: Eur Respir J Date: 2012-10-25 Impact factor: 16.671
Authors: Laura Geffner; Noemí Yokobori; Juan Basile; Pablo Schierloh; Luciana Balboa; María Mercedes Romero; Viviana Ritacco; Marisa Vescovo; Pablo González Montaner; Beatriz Lopez; Lucía Barrera; Mercedes Alemán; Eduardo Abatte; María C Sasiain; Silvia de la Barrera Journal: Infect Immun Date: 2009-08-31 Impact factor: 3.441
Authors: Mayara L Bastos; Hamidah Hussain; Karin Weyer; Lourdes Garcia-Garcia; Vaira Leimane; Chi Chiu Leung; Masahiro Narita; Jose M Penã; Alfredo Ponce-de-Leon; Kwonjune J Seung; Karen Shean; José Sifuentes-Osornio; Martie Van der Walt; Tjip S Van der Werf; Wing Wai Yew; Dick Menzies Journal: Clin Infect Dis Date: 2014-08-05 Impact factor: 9.079