Acquired Drug Resistance in Mycobacterium tuberculosis and Poor Outcomes among Patients with Multidrug-Resistant Tuberculosis
Published Date:Jun 2015
Source:Emerg Infect Dis. 21(6):992-1001.
Keywords:Acquired Drug Resistance
Acquired Drug Resistance In Mycobacterum Tuberculosis And Poor Outcomes Among Patients With Multdrug-Resistant Tuberculosis
Extensively Drug-resistant Tuberculosis
Tuberculosis And Other Mycobacteria
Funding:D43TW007124/TW/FIC NIH HHS/United States
K23AI103044/AI/NIAID NIH HHS/United States
UL1TR000454/TR/NCATS NIH HHS/United States
Description:Rates and risk factors for acquired drug resistance and association with outcomes among patients with multidrug-resistant tuberculosis (MDR TB) are not well defined. In an MDR TB cohort from the country of Georgia, drug susceptibility testing for second-line drugs (SLDs) was performed at baseline and every third month. Acquired resistance was defined as any SLD whose status changed from susceptible at baseline to resistant at follow-up. Among 141 patients, acquired resistance in Mycobacterium tuberculosis was observed in 19 (14%); prevalence was 9.1% for ofloxacin and 9.8% for capreomycin or kanamycin. Baseline cavitary disease and resistance to >6 drugs were associated with acquired resistance. Patients with M. tuberculosis that had acquired resistance were at significantly increased risk for poor treatment outcome compared with patients without these isolates (89% vs. 36%; p<0.01). Acquired resistance occurs commonly among patients with MDR TB and impedes successful treatment outcomes.
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