Details:

Alternative Title:
Int J Tuberc Lung Dis
Personal Author:
Shin, S. S. ; Asencios, L. ; Yagui, M. ; Yale, G. ; Suárez, C. ; ... More +
Shin, S. S. ; Asencios, L. ; Yagui, M. ; Yale, G. ; Suárez, C. ; Bayona, J. ; Bonilla, C. ; Jave, O. ; Contreras, C. C. ; Atwood, S. ; Blaya, J. A. ; Ershova, J. ; Cegielski, J. P. Less -
Description:
Setting

Programmatic implementation of decentralized rapid drug susceptibility testing (DST) in Lima, Peru.

Objective

Pre-post analysis compared time to diagnosis, treatment outcome and survival among patients tested with direct nitrate reductase assay (NRA) vs. indirect conventional methods.

Design

From 2005 to 2009, we prospectively followed all patients referred for DST before (control) and after (intervention) NRA implementation. Among those referred for DST, NRA was used for smear-positive samples of patients with no prior history of multidrug resistance or treatment for multidrug-resistant tuberculosis (TB). Data were abstracted from patient charts and laboratory registers. Endpoints were favorable outcomes, time to result and time to death.

Results

Of those patients who met the criteria for NRA, 740 underwent NRA and 621 underwent conventional DST. NRA yielded test results for 78.4% of cases vs. 68.8% for conventional DST (P < 0.0001); the median time to result was 44 vs. 133 days, respectively (adjusted HR 0.64, 95%CI 0.56–0.73). Among individuals without previous anti-tuberculosis treatment, NRA was associated with a favorable treatment outcome (adjusted OR 1.39, 95%CI 1.01–1.90) and prolonged survival (adjusted HR 0.53, 95%CI 0.31–0.90).

Conclusion

Direct NRA significantly shortened time to test result and improved treatment outcomes and survival in certain groups.


Subject:
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Adult Antitubercular Agents Article Female Humans Male Microbial Sensitivity Tests Middle Aged Mycobacterium Tuberculosis Prospective Studies Sputum Survival Rate Time Factors Treatment Outcome Tuberculosis Young Adult
Source:
Int J Tuberc Lung Dis. 16(11):1538-1543
Pubmed ID:
22990138
Pubmed Central ID:
PMC5788451
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; K23 AI054591/AI/NIAID NIH HHS/United States ; AI054591-01A2/AI/NIAID NIH HHS/United States
CC999999/Intramural CDC HHS/United States ; K23 AI054591/AI/NIAID NIH HHS/United States ; AI054591-01A2/AI/NIAID NIH HHS/United States Less -
Place as Subject:
Peru
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:5a4464078a1824b889f333ce893ff7203e0508ed25cad020a7028741fefe8554
Download URL:
https://stacks.cdc.gov/view/cdc/51241/cdc_51241_DS1.pdf
File Type:

Supporting Files

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