1629. Treatment Outcomes in Patients with Multi-drug Resistant Tuberculosis and Extensively Drug-Resistant Tuberculosis in China: Retrospective Multi-center Investigation
Session: Poster Abstract Session: Mycobacterial Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Poster 2 USA.pdf (893.2 kB)
  • Background: The increasing incidence of multidrug resistant tuberculosis (MDR-TB) and extensively drug-resistant (XDR- TB) is a major concern for TB control programs worldwide. To investigate the characteristics, treatment outcomes and risk factors associated with poor treatment outcomes among patients with MDR- and XDR-TB.

    Methods: We retrospectively analyzed TB Patients with culture-proven MDR-TB and HIV-negative in five large-scale Tuberculosis Specialized Hospitals in China.

    Results: Among 1662 TB cases with culture-positive for M. tuberculosis complex, 965 cases (58.1%) were drug resistant (DR), 586 cases (35.3%) were classified as having MDR-TB, accounting for 60.7% of DR-TB. 169 cases (10.2%) were XDR-TB, accounting for 17.5% of DR-TB, 28.8% of MDR-TB. The patients were divided into XDR-TB group (n=169) and other MDR-TB group (MDR-TB excluding XDR-TB or non-XDR MDR-TB) (n=417). In 586 MDR-TB cases, retreated patients accounted for 78.67% (461/586), there being no significant difference between the two groups. There were a much higher proportion of patients with comorbidity, decreased albumin, and cavitary disease among the patients with XDR group compared to patients in other MDR group. The course of disease in XDR group was 7.2±8.75 years, significantly higher than that in other MDR group. The resistance proportions of all drugs except isoniazid and rifampicin were significantly higher in patients with XDR-TB than in other MDR-TB patients. In total, 240 patients (40.95%) had treatment Success, and 346 (59.05%) had Poor treatment outcomes. The treatment success rate in other MDR-TB group was 52.2%, significantly higher than that in XDR-TB group(13%, P<0.001), whereas Poor treatment outcomes were more common in patients with XDR-TB than in patients with other MDR-TB (87 vs.47.8%; P<0.001). In multivariate logistic regression analysis, treatment success was associated with age less than 45 years, duration of earlier treatment less than one year, a BMI greater than 18.5 kg/m2, and new case. Meanwhile, XDR, Diabetes, Tumor, decreased albumin and with cavitation were independent predictors of poor treatment outcomes.

    Conclusion: The prevalence of MDR- and XDR-TB is high in some areas in China with poor treatment outcome. 

    Shenjie Tang1, Shouyong Tan2, Lan Yao1, Xiaohui Hao1, Fujian Li3, Li Li4 and Xinzhi Guo5, (1)Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China, (2)Guangzhou Chest Hospital, Guangzhou, China, (3)Hangzhou Red Cross Hospital, Hangzhou, China, (4)Tianjin Haihe Hospital, Tianjin, China, (5)Henan Infectious Hospital, Zhengzhou, China

    Disclosures:

    S. Tang, None

    S. Tan, None

    L. Yao, None

    X. Hao, None

    F. Li, None

    L. Li, None

    X. Guo, None

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