Treatment Practices, Outcomes, and Costs of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis, United States, 2005–2007

To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prev...

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Veröffentlicht in:Emerging infectious diseases Jg. 20; H. 5; S. 812 - 821
Hauptverfasser: Marks, Suzanne M., Flood, Jennifer, Seaworth, Barbara, Hirsch-Moverman, Yael, Armstrong, Lori, Mase, Sundari, Salcedo, Katya, Oh, Peter, Graviss, Edward A., Colson, Paul W., Armitige, Lisa, Revuelta, Manuel, Sheeran, Kathryn
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States U.S. National Center for Infectious Diseases 01.05.2014
Centers for Disease Control and Prevention
Schlagworte:
Analysis
Antitubercular agents
Antitubercular Agents - pharmacology
Antitubercular Agents - therapeutic use
Clinics
Comorbidity
cost
drug resistance
Drug resistance in microorganisms
Drug Therapy, Combination
Extensively Drug-Resistant Tuberculosis - drug therapy
Extensively Drug-Resistant Tuberculosis - epidemiology
Extensively Drug-Resistant Tuberculosis - history
Female
Health Care Costs
History, 21st Century
Humans
Male
multidrug-resistant tuberculosis
Mycobacterium tuberculosis - drug effects
Mycobacterium tuberculosis - genetics
Outcome Assessment, Health Care
outcomes
Risk Factors
Treatment Outcome
treatment practices
Tuberculosis
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - epidemiology
Tuberculosis, Multidrug-Resistant - history
United States - epidemiology
United States
New York
Texas
California
Tuberculosis
cost
United States
outcomes
extensively drug-resistant tuberculosis
tuberculosis and other mycobacteria
multidrug-resistant tuberculosis
drug resistance
treatment practices
TB
ISSN:1080-6040, 1080-6059, 1080-6059
Online-Zugang:Volltext
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Zusammenfassung:To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prevention from California, New York City, and Texas during 2005-2007. At initial diagnosis, MDR TB was detected in 94% of 130 MDR TB patients and XDR TB in 80% of 5 XDR TB patients. Mutually exclusive resistance was 4% XDR, 17% pre-XDR, 24% total first-line resistance, 43% isoniazid/rifampin/rifabutin-plus-other resistance, and 13% isoniazid/rifampin/rifabutin-only resistance. Nearly three-quarters of patients were hospitalized, 78% completed treatment, and 9% died during treatment. Direct costs, mostly covered by the public sector, averaged $134,000 per MDR TB and $430,000 per XDR TB patient; in comparison, estimated cost per non-MDR TB patient is $17,000. Drug resistance was extensive, care was complex, treatment completion rates were high, and treatment was expensive.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1080-6040
1080-6059
1080-6059
DOI:10.3201/eid2005.131037