Isoniazid-monoresistant tuberculosis is associated with poor treatment outcomes in Durban, South Africa.
Int J Tuberc Lung Dis
; 21(6): 670-676, 2017 06 01.
Article
en En
| MEDLINE
| ID: mdl-28482962
ABSTRACT
SETTING:
A large tuberculosis (TB) clinic in Durban, South Africa.OBJECTIVE:
To determine the association between isoniazid (INH) monoresistant TB and treatment outcomes.DESIGN:
We performed a retrospective longitudinal study of patients seen from 2000 to 2012 to compare episodes of INH-monoresistant TB with those of drug-susceptible TB using logistic regression with robust standard errors. INH-monoresistant TB was treated with modified regimens.RESULTS:
Among 18 058 TB patients, there were 19 979 TB episodes for which drug susceptibility testing was performed. Of these, 557 were INH-monoresistant and 16 311 were drug-susceptible. Loss to follow-up, transfer, and human immunodeficiency virus (HIV) co-infection (41% had known HIV status) were similar between groups. INH-monoresistant episodes were more likely to result in treatment failure (4.1% vs. 0.6%, P < 0.001) and death (3.2% vs. 1.8%, P = 0.01) than drug-susceptible episodes. After adjustment for age, sex, race, retreatment status, and disease site, INH-monoresistant episodes were more likely to have resulted in treatment failure (OR 6.84, 95%CI 4.29-10.89, P < 0.001) and death (OR 1.81, 95%CI 1.11-2.95, P = 0.02).CONCLUSION:
INH monoresistance was associated with worse clinical outcomes than drug-susceptible TB. Our findings support the need for rapid diagnostic tests for INH resistance and improved treatment regimens for INH-monoresistant TB.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Tuberculosis
/
Isoniazida
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Mycobacterium tuberculosis
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Antituberculosos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
País como asunto:
Africa
Idioma:
En
Año:
2017
Tipo del documento:
Article