Caihong Xu1, Yu Pang2, Renzhong Li1, Yunzhou Ruan1, Lixia Wang1, Mingting Chen1, Hui Zhang3. 1. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 2. National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory on Drug-resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China. 3. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: zhanghui@chinatb.org.
Abstract
OBJECTIVES: The aim of this study was to retrospectively analyze the clinical outcome and the risk factors associated with poor outcome of MDR-TB patients receiving standardized second-line treatment regimen in China. METHODS: Between January 2008 and December 2010, a total of 12,100 clinical diagnosed TB cases at high risk of drug-resistant TB (DR-TB) were enrolled in this study. Routine follow-up tests were conducted every month during the 6-month intensive phase, and every two months during the 18-month continuation phase. RESULTS: On the basis of phenotypical drug susceptibility test (DST) results, 2322 MDR-TB patients were confirmed, of which 1542 further received standardized second-line anti-TB regimen. The treatment success rate was 47.6% (734/1542): 688 patients (44.6%) were cured and 46 (3.0%) completed treatment. The percentage of cases with favorable outcome in previously untreated patients (57.6%) was significantly higher than that in treatment-experienced patients (46.1%, OR: 1.58, 95% CI: 1.17-2.14). In addition, a significant lower percentage of male MDR-TB cases with favorable outcome (45.8%) was observed using female MDR-TB cases as a reference (52.0%, OR: 1.31, 95% CI: 1.03-1.60). The proportion of MDR-TB cases with favorable outcome was significantly decreased in older age groups. CONCLUSIONS: In conclusion, our data demonstrate that less than half of these patients receiving standardized second-line treatment regimen meet the definition of successful treatment during a 3-year period in China. More attention should be paid to the MDR-TB population at high-risk of poor clinical outcome, including male, elderly age, and those who have received prior treatment.
OBJECTIVES: The aim of this study was to retrospectively analyze the clinical outcome and the risk factors associated with poor outcome of MDR-TBpatients receiving standardized second-line treatment regimen in China. METHODS: Between January 2008 and December 2010, a total of 12,100 clinical diagnosed TB cases at high risk of drug-resistant TB (DR-TB) were enrolled in this study. Routine follow-up tests were conducted every month during the 6-month intensive phase, and every two months during the 18-month continuation phase. RESULTS: On the basis of phenotypical drug susceptibility test (DST) results, 2322 MDR-TBpatients were confirmed, of which 1542 further received standardized second-line anti-TB regimen. The treatment success rate was 47.6% (734/1542): 688 patients (44.6%) were cured and 46 (3.0%) completed treatment. The percentage of cases with favorable outcome in previously untreated patients (57.6%) was significantly higher than that in treatment-experienced patients (46.1%, OR: 1.58, 95% CI: 1.17-2.14). In addition, a significant lower percentage of male MDR-TB cases with favorable outcome (45.8%) was observed using female MDR-TB cases as a reference (52.0%, OR: 1.31, 95% CI: 1.03-1.60). The proportion of MDR-TB cases with favorable outcome was significantly decreased in older age groups. CONCLUSIONS: In conclusion, our data demonstrate that less than half of these patients receiving standardized second-line treatment regimen meet the definition of successful treatment during a 3-year period in China. More attention should be paid to the MDR-TB population at high-risk of poor clinical outcome, including male, elderly age, and those who have received prior treatment.
Authors: María Luisa Aznar; Ariadna Rando Segura; María Milagros Moreno; Mateu Espasa; Elena Sulleiro; Cristina Bocanegra; Eva Gil Olivas; Arlete Nindia Eugénio; Adriano Zacarias; Domingos Katimba; Estevao Gabriel; Jacobo Mendioroz; Maria Teresa López García; Tomas Pumarola; María Teresa Tórtola; Israel Molina Journal: Am J Trop Med Hyg Date: 2019-09 Impact factor: 2.345
Authors: Qingchun Li; Cynthia X Shi; Min Lu; Limin Wu; Yifei Wu; Meng Wang; Le Wang; Gang Zhao; Li Xie; Han-Zhu Qian Journal: Medicine (Baltimore) Date: 2020-07-24 Impact factor: 1.817