OBJECTIVE: To assess outcomes 24 months after treatment start for multidrug-resistant tuberculosis (MDR-TB). METHODS: Cohort study of all culture-positive MDR-TB cases notified in Switzerland from 01/2003 to 07/2010. RESULTS: Fifty-one cases were observed, with a median age of 26 years (range 2-56). Twenty-seven were male, five of Swiss origin, 46 of foreign origin (Asia 18, Africa 13, former Soviet Union 8), including 21 asylum seekers and refugees. Twelve had received a previous treatment for TB and 24 had not (15 unknown). Forty-four cases were pulmonary of which 25 were known to be sputum smear positive. All but two strains showed additional resistances: 29 to ethambutol, 27 to pyrazinamide, 6 to a fluoroquinolone, 5 to amikacin. None was resistant to both of the latter two classes. Molecular analyses showed three pairs of identical strains. Fluoroquinolones were used in 48 patients and second-line injectable drugs in 37. The median duration of MDR treatment was 18 months (range 1-26). The outcome after 24 months was successful in 39 (76%) and unsatisfactory in 12 (24%) patients: two deaths from TB; two treatments terminated owing to side effects of drugs and one owing to pregnancy; four defaults from treatment at months 0, 4, 8, and 21; two transfers abroad with unknown outcome; one outcome unknown. There was no significant association of unfavourable outcomes with age, sex, origin, previous treatment, treatment delay, resistance pattern, and classes of drugs used. CONCLUSIONS: MDR-TB in Switzerland occurs mostly in persons of foreign origin. Results of decentralised treatments were satisfactory.
OBJECTIVE: To assess outcomes 24 months after treatment start for multidrug-resistant tuberculosis (MDR-TB). METHODS: Cohort study of all culture-positive MDR-TB cases notified in Switzerland from 01/2003 to 07/2010. RESULTS: Fifty-one cases were observed, with a median age of 26 years (range 2-56). Twenty-seven were male, five of Swiss origin, 46 of foreign origin (Asia 18, Africa 13, former Soviet Union 8), including 21 asylum seekers and refugees. Twelve had received a previous treatment for TB and 24 had not (15 unknown). Forty-four cases were pulmonary of which 25 were known to be sputum smear positive. All but two strains showed additional resistances: 29 to ethambutol, 27 to pyrazinamide, 6 to a fluoroquinolone, 5 to amikacin. None was resistant to both of the latter two classes. Molecular analyses showed three pairs of identical strains. Fluoroquinolones were used in 48 patients and second-line injectable drugs in 37. The median duration of MDR treatment was 18 months (range 1-26). The outcome after 24 months was successful in 39 (76%) and unsatisfactory in 12 (24%) patients: two deaths from TB; two treatments terminated owing to side effects of drugs and one owing to pregnancy; four defaults from treatment at months 0, 4, 8, and 21; two transfers abroad with unknown outcome; one outcome unknown. There was no significant association of unfavourable outcomes with age, sex, origin, previous treatment, treatment delay, resistance pattern, and classes of drugs used. CONCLUSIONS: MDR-TB in Switzerland occurs mostly in persons of foreign origin. Results of decentralised treatments were satisfactory.
Authors: Abdurahman Abibeker Omer; Meiraf Daniel Meshesha; Abraham Teka Ajema; Samuel D Yoo Journal: Infect Drug Resist Date: 2022-08-22 Impact factor: 4.177
Authors: Rebecca C Harris; Louis Grandjean; Laura J Martin; Alexander J P Miller; Joseph-Egre N Nkang; Victoria Allen; Mishal S Khan; Katherine Fielding; David A J Moore Journal: BMC Infect Dis Date: 2016-05-04 Impact factor: 3.090
Authors: Ye Minn Htun; Tin Mi Mi Khaing; Nay Myo Aung; Yin Yin; Zaw Myint; Si Thu Aung; Ngamphol Soonthornworasiri; Udomsak Silachamroon; Yuthichai Kasetjaroen; Jaranit Kaewkungwal Journal: PLoS One Date: 2018-12-31 Impact factor: 3.240