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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
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TitleCharacteristics and treatment outcomes of patients with MDR and XDR tuberculosis in a TB referral hospital in beijing: A 13-year experience
 
AuthorsLiu, CH2 3
Li, L1
Chen, Z3
Wang, Q2
Hu, YL3
Zhu, B2
Woo, PCY4
 
Issue Date2011
 
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
CitationPlos One, 2011, v. 6 n. 4 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0019399
 
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.
 
DescriptionOpen Access Journal
link_to_OA_fulltext
 
ISSN1932-6203
2012 Impact Factor: 3.73
2012 SCImago Journal Rankings: 1.512
 
DOIhttp://dx.doi.org/10.1371/journal.pone.0019399
 
PubMed Central IDPMC3084844
 
ISI Accession Number IDWOS:000290024700158
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.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLiu, CH
 
dc.contributor.authorLi, L
 
dc.contributor.authorChen, Z
 
dc.contributor.authorWang, Q
 
dc.contributor.authorHu, YL
 
dc.contributor.authorZhu, B
 
dc.contributor.authorWoo, PCY
 
dc.date.accessioned2011-08-26T14:24:47Z
 
dc.date.available2011-08-26T14:24:47Z
 
dc.date.issued2011
 
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.
 
dc.description.naturepublished_or_final_version
 
dc.descriptionOpen Access Journal
 
dc.descriptionlink_to_OA_fulltext
 
dc.identifier.citationPlos One, 2011, v. 6 n. 4 [How to Cite?]
DOI: http://dx.doi.org/10.1371/journal.pone.0019399
 
dc.identifier.doihttp://dx.doi.org/10.1371/journal.pone.0019399
 
dc.identifier.epagee19399
 
dc.identifier.hkuros190745
 
dc.identifier.isiWOS:000290024700158
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.

 
dc.identifier.issn1932-6203
2012 Impact Factor: 3.73
2012 SCImago Journal Rankings: 1.512
 
dc.identifier.issue4
 
dc.identifier.pmcidPMC3084844
 
dc.identifier.pmid21559362
 
dc.identifier.scopuseid_2-s2.0-79955783080
 
dc.identifier.spagee19399
 
dc.identifier.urihttp://hdl.handle.net/10722/137420
 
dc.identifier.volume6
 
dc.languageeng
 
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
 
dc.publisher.placeUnited States
 
dc.relation.ispartofPLoS ONE
 
dc.relation.referencesReferences in Scopus
 
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 experience
 
dc.typeArticle
 
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<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. &#169; 2011 Liu et al.</description.abstract>
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Author Affiliations
  1. Southern Medical University
  2. Institute of Microbiology Chinese Academy of Sciences
  3. 309th Hospital of Chinese PLA
  4. The University of Hong Kong