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Article: Characteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience

TitleCharacteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience
Authors
Issue Date2011
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2011, v. 6 n. 4 How to Cite?
Abstract
Background: Information on treatment outcomes among hospitalized patients with multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are scarce in China. Methodology/Principal Findings: We conducted this retrospective study to analyze the characteristics and treatment outcomes in MDR- and XDR-TB patients in the 309 Hospital in Beijing, China during 1996-2009. Socio-demographic and clinical data were retrieved from medical records and analyzed. Logistic regression analysis was performed to identify risk factors associated with poor treatment outcomes and Cox proportional hazards regression model was further used to determine risk factors associated with death in TB patients. Among the 3,551 non-repetitive hospitalized TB patients who had drug susceptibility testing (DST) results, 716 (20.2%) had MDR-TB and 51 (1.4%) had XDR-TB. A total of 3,270 patients who had medical records available were used for further analyses. Treatment success rates (cured and treatment completed) were 90.9%, 53.4% and 29.2% for patients with non-MDR-TB, patients with MDR-TB excluding XDR-TB and patients with XDR-TB, respectively. Independent risk factors associated with poor treatment outcomes in MDR-TB patients included being a migrant (adjusted OR = 1.77), smear-positivity at treatment onset (adjusted OR = 1.94) and not receiving 3 or more potentially effective drugs (adjusted OR = 3.87). Independent risk factors associated with poor treatment outcomes in XDR-TB patients were smear-positivity at treatment onset (adjusted OR = 10.42) and not receiving 3 or more potentially effective drugs (adjusted OR = 14.90). The independent risk factors associated with death in TB patients were having chronic obstructive pulmonary disease (adjusted HR = 5.25) and having hypertension (adjusted HR = 4.31). Conclusions/Significance: While overall satisfactory treatment success for non-MDR-TB patients was achieved, more intensive efforts should be made to better manage MDR- and XDR-TB cases in order to improve their treatment outcomes and to minimize further emergence of so-called totally drug-resistant TB cases. © 2011 Liu et al.
DescriptionOpen Access Journal
Persistent Identifierhttp://hdl.handle.net/10722/137420
ISSN
2013 Impact Factor: 3.534
2013 SCImago Journal Rankings: 1.724
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
309 Hospital, Beijing, China09QD01
State Key Development Program for Basic Research of China, China2009CB522605
Chinese Academy of SciencesKSCX2-EW-J-6
KSCX2-YW-R-164
Funding Information:

This research project received funding from the Start-up Grant of the 309 Hospital, Beijing, China (09QD01) and the State Key Development Program for Basic Research of China, China (2009CB522605). This work was supported by the Knowledge Innovation Program of the Chinese Academy of Sciences (KSCX2-EW-J-6 and KSCX2-YW-R-164). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CHen_HK
dc.contributor.authorLi, Len_HK
dc.contributor.authorChen, Zen_HK
dc.contributor.authorWang, Qen_HK
dc.contributor.authorHu, YLen_HK
dc.contributor.authorZhu, Ben_HK
dc.contributor.authorWoo, PCYen_HK
dc.date.accessioned2011-08-26T14:24:47Z-
dc.date.available2011-08-26T14:24:47Z-
dc.date.issued2011en_HK
dc.identifier.citationPlos One, 2011, v. 6 n. 4en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137420-
dc.descriptionOpen Access Journal-
dc.descriptionlink_to_OA_fulltext-
dc.description.abstractBackground: Information on treatment outcomes among hospitalized patients with multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are scarce in China. Methodology/Principal Findings: We conducted this retrospective study to analyze the characteristics and treatment outcomes in MDR- and XDR-TB patients in the 309 Hospital in Beijing, China during 1996-2009. Socio-demographic and clinical data were retrieved from medical records and analyzed. Logistic regression analysis was performed to identify risk factors associated with poor treatment outcomes and Cox proportional hazards regression model was further used to determine risk factors associated with death in TB patients. Among the 3,551 non-repetitive hospitalized TB patients who had drug susceptibility testing (DST) results, 716 (20.2%) had MDR-TB and 51 (1.4%) had XDR-TB. A total of 3,270 patients who had medical records available were used for further analyses. Treatment success rates (cured and treatment completed) were 90.9%, 53.4% and 29.2% for patients with non-MDR-TB, patients with MDR-TB excluding XDR-TB and patients with XDR-TB, respectively. Independent risk factors associated with poor treatment outcomes in MDR-TB patients included being a migrant (adjusted OR = 1.77), smear-positivity at treatment onset (adjusted OR = 1.94) and not receiving 3 or more potentially effective drugs (adjusted OR = 3.87). Independent risk factors associated with poor treatment outcomes in XDR-TB patients were smear-positivity at treatment onset (adjusted OR = 10.42) and not receiving 3 or more potentially effective drugs (adjusted OR = 14.90). The independent risk factors associated with death in TB patients were having chronic obstructive pulmonary disease (adjusted HR = 5.25) and having hypertension (adjusted HR = 4.31). Conclusions/Significance: While overall satisfactory treatment success for non-MDR-TB patients was achieved, more intensive efforts should be made to better manage MDR- and XDR-TB cases in order to improve their treatment outcomes and to minimize further emergence of so-called totally drug-resistant TB cases. © 2011 Liu et al.en_HK
dc.languageengen_US
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPLoS ONEen_HK
dc.subject.meshAntitubercular Agents - therapeutic use-
dc.subject.meshExtensively Drug-Resistant Tuberculosis - drug therapy-
dc.subject.meshMycobacterium tuberculosis - metabolism-
dc.subject.meshProportional Hazards Models-
dc.subject.meshTuberculosis, Multidrug-Resistant - drug therapy-
dc.titleCharacteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experienceen_HK
dc.typeArticleen_HK
dc.identifier.emailWoo, PCY:pcywoo@hkucc.hku.hken_HK
dc.identifier.authorityWoo, PCY=rp00430en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0019399en_HK
dc.identifier.pmid21559362-
dc.identifier.pmcidPMC3084844-
dc.identifier.scopuseid_2-s2.0-79955783080en_HK
dc.identifier.hkuros190745en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79955783080&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume6en_HK
dc.identifier.issue4en_HK
dc.identifier.spagee19399en_US
dc.identifier.epagee19399en_US
dc.identifier.isiWOS:000290024700158-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CH=37122181000en_HK
dc.identifier.scopusauthoridLi, L=36079389000en_HK
dc.identifier.scopusauthoridChen, Z=52163282200en_HK
dc.identifier.scopusauthoridWang, Q=35742090000en_HK
dc.identifier.scopusauthoridHu, YL=38961464300en_HK
dc.identifier.scopusauthoridZhu, B=7401683108en_HK
dc.identifier.scopusauthoridWoo, PCY=7201801340en_HK

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