Treatment and Outcome Analysis of 205 Patients with Multidrug-resistant Tuberculosis

Multidrug-resistant tuberculosis, a disease caused by Mycobacterium tuberculosis strains that are resistant at least to rifampin and isoniazid, entails extended treatment, expensive and toxic regimens, and higher rates of treatment failure and death. We retrospectively analyzed the outcomes in 205 p...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:American journal of respiratory and critical care medicine Ročník 169; číslo 10; s. 1103 - 1109
Hlavní autori: Chan, Edward D, Laurel, Valerie, Strand, Matthew J, Chan, Julanie F, Huynh, Mai-Lan N, Goble, Marian, Iseman, Michael D
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: New York, NY Am Thoracic Soc 15.05.2004
American Lung Association
American Thoracic Society
Predmet:
Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antitubercular Agents - administration & dosage
Biological and medical sciences
Child
Child, Preschool
Clinical outcomes
Cohort Studies
Drug resistance
Drug Resistance, Multiple, Bacterial
Drug Therapy, Combination
Failure
Female
Fluoroquinolones - administration & dosage
Humans
Intensive care medicine
Logistic Models
Male
Medical sciences
Microbial Sensitivity Tests
Middle Aged
Mortality
Multidrug resistant organisms
Multivariate Analysis
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - isolation & purification
Patients
Prognosis
Respiratory failure
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sputum - microbiology
Success
Survival Analysis
Thoracic surgery
Toxicity
Treatment Outcome
Tuberculosis
Tuberculosis, Multidrug-Resistant - diagnosis
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - mortality
Human
Treatment resistance
Intensive care
Prognosis
Mycobacterial infection
Infection
Treatment
Tuberculosis
Mycobacterium tuberculosis
Mycobacteriales
Surgery
Bacteriosis
Mycobacteriaceae
Bacteria
Actinomycetes
drug resistance
fluoroquinolones
Resuscitation
ISSN:1073-449X, 1535-4970
On-line prístup:Získať plný text
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:Multidrug-resistant tuberculosis, a disease caused by Mycobacterium tuberculosis strains that are resistant at least to rifampin and isoniazid, entails extended treatment, expensive and toxic regimens, and higher rates of treatment failure and death. We retrospectively analyzed the outcomes in 205 patients treated at our center for multidrug-resistant tuberculosis, with strains resistant to a median of six drugs, and compared the results with those of our previous series. Logistic regression and survival analysis were used to evaluate short- and long-term outcomes, respectively. Initial favorable response, defined as at least three consecutive negative sputum cultures over a period of at least 3 months, was 85% compared with 65% in the prior cohort. The current cohort had greater long-term success rates, 75% versus 56%, and lower tuberculosis death rates, 12% versus 22%, than the earlier one. Surgical resection and fluoroquinolone therapy were associated with improved microbiological and clinical outcomes in the 205 patients studied after adjusting for other variables. The improvement was statistically significant for surgery and among older patients for fluoroquinolone therapy.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.200308-1159OC