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

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  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
• Corporate Authors:
  TB Epidemiologic Studies Consortium
• Description:
  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.
• Subjects:
  Antitubercular Agents Comorbidity Drug Therapy, Combination Extensively Drug-Resistant Tuberculosis Female Health Care Costs History, 21st Century Humans Male Mycobacterium Tuberculosis Outcome Assessment (Health Care) Research Risk Factors Treatment Outcome Tuberculosis, Multidrug-Resistant

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• Source:
  Emerg Infect Dis. 20(5):812-821.
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Location:
  North America
• Volume:
  20
• Issue:
  5
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:6a651ab21390c95ebb9dee5c2cc608199f74aa13ac0d17c92d87e9fe80b340e8
• Download URL:
  https://stacks.cdc.gov/view/cdc/23059/cdc_23059_DS1.pdf
• File Type:
  [PDF - 590.41 KB ]