Lisa Sharling1, Suzanne M Marks2, Michael Goodman3, Terence Chorba2, Sundari Mase4. 1. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine. 2. Division of Tuberculosis Elimination, Centers for Disease Control and Prevention. 3. Department of Health and Human Services, Emory University Rollins School of Public Health, Atlanta, Georgia. 4. World Health Organization, Tuberculosis Department, Country Office for India, New Delhi.
Abstract
BACKGROUND: Monoresistance to rifamycins necessitates longer and more toxic regimens for tuberculosis (TB). We examined characteristics and mortality associated with rifampin-monoresistant (RMR) TB in the United States. METHODS: We analyzed Mycobacterium tuberculosis culture-positive cases reported to the National TB Surveillance System (excluding California) between 1998 and 2014. We defined RMR TB found on initial drug susceptibility testing and possible acquired rifampin-resistant (ARR) TB. We assessed temporal trends in RMR TB. For both classifications of rifampin resistance, we calculated adjusted risk ratios (adjRRs) and 95% confidence intervals (CIs) for characteristics associated with mortality when compared with drug-susceptible TB in multivariable models using backward selection. RESULTS: Of 180 329 TB cases, 126 431 (70%) were eligible for analysis, with 359 (0.28%) of eligible cases reported as RMR. The percentage of RMR TB cases with HIV declined 4% annually between 1998 and 2014. Persons with HIV and prior TB were more likely to have RMR TB (adjRR, 25.9; 95% CI, 17.6-38.1), as were persons with HIV and no prior TB (adjRR, 3.1; 95% CI, 2.4-4.1) vs those without either characteristic, controlling for other statistically significant variables. RMR cases had greater mortality (adjRR, 1.4; 95% CI, 1.04-1.8), controlling for HIV and other variables. Persons with HIV had greater risk of ARR than persons without HIV (adjRR, 9.6; 95% CI, 6.9-13.3), and ARR was also associated with increased mortality, controlling for HIV and other variables. CONCLUSIONS: All forms of rifampin resistance were positively associated with HIV infection and increased mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
BACKGROUND: Monoresistance to rifamycins necessitates longer and more toxic regimens for tuberculosis (TB). We examined characteristics and mortality associated with rifampin-monoresistant (RMR) TB in the United States. METHODS: We analyzed Mycobacterium tuberculosis culture-positive cases reported to the National TB Surveillance System (excluding California) between 1998 and 2014. We defined RMR TB found on initial drug susceptibility testing and possible acquired rifampin-resistant (ARR) TB. We assessed temporal trends in RMR TB. For both classifications of rifampin resistance, we calculated adjusted risk ratios (adjRRs) and 95% confidence intervals (CIs) for characteristics associated with mortality when compared with drug-susceptible TB in multivariable models using backward selection. RESULTS: Of 180 329 TB cases, 126 431 (70%) were eligible for analysis, with 359 (0.28%) of eligible cases reported as RMR. The percentage of RMR TB cases with HIV declined 4% annually between 1998 and 2014. Persons with HIV and prior TB were more likely to have RMR TB (adjRR, 25.9; 95% CI, 17.6-38.1), as were persons with HIV and no prior TB (adjRR, 3.1; 95% CI, 2.4-4.1) vs those without either characteristic, controlling for other statistically significant variables. RMR cases had greater mortality (adjRR, 1.4; 95% CI, 1.04-1.8), controlling for HIV and other variables. Persons with HIV had greater risk of ARR than persons without HIV (adjRR, 9.6; 95% CI, 6.9-13.3), and ARR was also associated with increased mortality, controlling for HIV and other variables. CONCLUSIONS: All forms of rifampin resistance were positively associated with HIV infection and increased mortality. Published by Oxford University Press for the Infectious Diseases Society of America 2019.
Entities:
Keywords:
HIV; drug resistance; isoniazid; rifampin; tuberculosis
Authors: D V Havlir; M P Dubé; F R Sattler; D N Forthal; C A Kemper; M W Dunne; D M Parenti; J P Lavelle; A C White; M D Witt; S A Bozzette; J A McCutchan Journal: N Engl J Med Date: 1996-08-08 Impact factor: 91.245
Authors: Jordan W Tappero; Williamson Z Bradford; Tracy B Agerton; Philip Hopewell; Arthur L Reingold; Shahin Lockman; Aderonke Oyewo; Elizabeth A Talbot; Thomas A Kenyon; Themba L Moeti; Howard J Moffat; Charles A Peloquin Journal: Clin Infect Dis Date: 2005-07-08 Impact factor: 9.079
Authors: Catharina C Boehme; Pamela Nabeta; Doris Hillemann; Mark P Nicol; Shubhada Shenai; Fiorella Krapp; Jenny Allen; Rasim Tahirli; Robert Blakemore; Roxana Rustomjee; Ana Milovic; Martin Jones; Sean M O'Brien; David H Persing; Sabine Ruesch-Gerdes; Eduardo Gotuzzo; Camilla Rodrigues; David Alland; Mark D Perkins Journal: N Engl J Med Date: 2010-09-01 Impact factor: 91.245
Authors: R Ridzon; C G Whitney; M T McKenna; J P Taylor; S H Ashkar; A T Nitta; S M Harvey; S Valway; C Woodley; R Cooksey; I M Onorato Journal: Am J Respir Crit Care Med Date: 1998-06 Impact factor: 21.405
Authors: Rebekah A Adams; Gabrielle Leon; Natalia M Miller; Saira P Reyes; Chantal H Thantrong; Alina M Thokkadam; Annabel S Lemma; Darshan M Sivaloganathan; Xuanqing Wan; Mark P Brynildsen Journal: J Antibiot (Tokyo) Date: 2021-08-16 Impact factor: 2.649
Authors: Helen Cox; Zubeida Salaam-Dreyer; Galo A Goig; Mark P Nicol; Fabrizio Menardo; Anzaan Dippenaar; Erika Mohr-Holland; Johnny Daniels; Patrick G T Cudahy; Sonia Borrell; Miriam Reinhard; Anna Doetsch; Christian Beisel; Anja Reuter; Jennifer Furin; Sebastien Gagneux; Robin M Warren Journal: Lancet Microbe Date: 2021-11
Authors: Zubeida Salaam-Dreyer; Elizabeth M Streicher; Frederick A Sirgel; Fabrizio Menardo; Sonia Borrell; Miriam Reinhard; Anna Doetsch; Patrick G T Cudahy; Erika Mohr-Holland; Johnny Daniels; Anzaan Dippenaar; Mark P Nicol; Sebastien Gagneux; Robin M Warren; Helen Cox Journal: Antimicrob Agents Chemother Date: 2021-08-30 Impact factor: 5.191
Authors: Joseph Baruch Baluku; Pallen Mugabe; Rose Mulwana; Sylvia Nassozi; Richard Katuramu; William Worodria Journal: Biomed Res Int Date: 2020-07-25 Impact factor: 3.411
Authors: Suay Hong Gan; Kyi Win KhinMar; Li Wei Ang; Leo K Y Lim; Li Hwei Sng; Yee Tang Wang; Cynthia B E Chee Journal: Open Forum Infect Dis Date: 2021-06-27 Impact factor: 3.835