Article: Characteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience
| Title | Characteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Authors | Liu, CH2 3 Li, L1 Chen, Z3 Wang, Q2 Hu, YL3 Zhu, B2 Woo, PCY4 | ||||||||
| Issue Date | 2011 | ||||||||
| Publisher | Public 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?] DOI: http://dx.doi.org/10.1371/journal.pone.0019399 | ||||||||
| 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. | ||||||||
| Description | Open Access Journal link_to_OA_fulltext | ||||||||
| ISSN | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||||
| DOI | http://dx.doi.org/10.1371/journal.pone.0019399 | ||||||||
| ISI Accession Number ID | WOS:000290024700158
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. | ||||||||
| PubMed Central ID | PMC3084844 | ||||||||
| References | References in Scopus |
| dc.contributor.author | Liu, CH | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| dc.contributor.author | Li, L | ||||||||
| dc.contributor.author | Chen, Z | ||||||||
| dc.contributor.author | Wang, Q | ||||||||
| dc.contributor.author | Hu, YL | ||||||||
| dc.contributor.author | Zhu, B | ||||||||
| dc.contributor.author | Woo, PCY | ||||||||
| dc.date.accessioned | 2011-08-26T14:24:47Z | ||||||||
| dc.date.available | 2011-08-26T14:24:47Z | ||||||||
| dc.date.issued | 2011 | ||||||||
| dc.description.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. | ||||||||
| dc.description.nature | published_or_final_version | ||||||||
| dc.description | Open Access Journal | ||||||||
| dc.description | link_to_OA_fulltext | ||||||||
| dc.identifier.citation | Plos One, 2011, v. 6 n. 4 [How to Cite?] DOI: http://dx.doi.org/10.1371/journal.pone.0019399 | ||||||||
| dc.identifier.doi | http://dx.doi.org/10.1371/journal.pone.0019399 | ||||||||
| dc.identifier.epage | e19399 | ||||||||
| dc.identifier.hkuros | 190745 | ||||||||
| dc.identifier.isi | WOS:000290024700158
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. | ||||||||
| dc.identifier.issn | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||||
| dc.identifier.issue | 4 | ||||||||
| dc.identifier.pmcid | PMC3084844 | ||||||||
| dc.identifier.pmid | 21559362 | ||||||||
| dc.identifier.scopus | eid_2-s2.0-79955783080 | ||||||||
| dc.identifier.spage | e19399 | ||||||||
| dc.identifier.uri | http://hdl.handle.net/10722/137420 | ||||||||
| dc.identifier.volume | 6 | ||||||||
| dc.language | eng | ||||||||
| dc.publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | ||||||||
| dc.publisher.place | United States | ||||||||
| dc.relation.ispartof | PLoS ONE | ||||||||
| dc.relation.references | References in Scopus | ||||||||
| dc.subject.mesh | Antitubercular Agents - therapeutic use | ||||||||
| dc.subject.mesh | Extensively Drug-Resistant Tuberculosis - drug therapy | ||||||||
| dc.subject.mesh | Mycobacterium tuberculosis - metabolism | ||||||||
| dc.subject.mesh | Proportional Hazards Models | ||||||||
| dc.subject.mesh | Tuberculosis, Multidrug-Resistant - drug therapy | ||||||||
| dc.title | Characteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience | ||||||||
| dc.type | Article |
Author Affiliations
- Southern Medical University
- Institute of Microbiology Chinese Academy of Sciences
- 309th Hospital of Chinese PLA
- The University of Hong Kong