Prevalence and treatment outcome of extensively drug-resistant tuberculosis plus additional drug resistance from the National Clinical Center for Tuberculosis in China: A five-year review
Objectives: The objective of this study was to explore the prevalence and primary clinical outcomes of extensively drug-resistant tuberculosis plus addition resistance to all drug tested (XDR-TB-Plus) between 2011 and 2015 in Beijing Chest Hospital. Methods: We retrospectively reviewed the drug susceptibility testing (DST) results of clinical Mycobacterium tuberculosis (MTB) strains from TB patients seeking health care in the National Clinical Center for Tuberculosis, between 2011 and 2015. The medical records of patients classified as XDR-TB-Plus were reviewed, including demographic characteristics, treatment regimen, and treatment outcome. Results: Of 9544 MTB isolates, there were 3376 (35.4%), 842 (8.8%) and 61 (0.64%) isolates identified as multidrug resistant tuberculosis (MDR-TB), extensively drug resistant tuberculosis (XDR-TB) and XDR-TB-Plus, respectively. The proportion of XDR-TB showed significant increase from 6.3% in 2011 to 9.1% in 2015 (Chi-square trend 5.94, P = 0.015). Similarly, the proportion of XDR-TB-Plus seemed to increase from 0.46% in 2011 to 0.74% in 2015, while the increasing trend was not significant (Chi-square trend 1.50, P = 0.221). The most frequently prescribed anti-TB drug was moxifloxacin (18/29, 62.1%), followed by protionamide (16/29, 55.2%), clofazimine (15/29, 51.7%), and pyrazinamide (15/29, 51.7%). Patients receiving regimens containing linezolid (LZD) were almost 27 times more likely to have favorable treatment outcome compared with those receiving regimens without LZD [odds ratios = 27.00; 95% CI = 2.50-291.19; P = 0.003]. Conclusions: In conclusion, our data have demonstrated that the proportion of XDR-TB has significantly increased over the past five years in Beijing Chest Hospital. In addition, the XDR-TB- Plus patients were more likely to reach favorable clinical outcome under the treatment of regimen containing LZD. (C) 2017 Published by Elsevier Ltd on behalf of The British Infection Association.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81401739]; National Key Project [2008ZX10003015]
通讯机构:[1]Capital Med Univ, Beijing TB & Thorac Tumor Inst, Beijing Chest Hosp, Beijing Key Lab Drugresistant TB,Natl Clin Lab TB, Beijing, Peoples R China;[3]Capital Med Univ, Beijing TB & Thorac Tumor Inst, Beijing Chest Hosp, Dept TB,Beijing Key Lab Drug Resistant TB Res, Beijing, Peoples R China;[4]Capital Med Univ, Beijing Chest Hosp, TB Dept, Beijing 101149, Peoples R China;[5]Capital Med Univ, Beijing Chest Hosp, Natl Clin Lab TB, Beijing 101149, Peoples R China
推荐引用方式(GB/T 7714):
Pang Yu,Lu Jie,Huo Fengmin,et al.Prevalence and treatment outcome of extensively drug-resistant tuberculosis plus additional drug resistance from the National Clinical Center for Tuberculosis in China: A five-year review[J].JOURNAL OF INFECTION.2017,75(5):433-440.doi:10.1016/j.jinf.2017.08.005.
APA:
Pang, Yu,Lu, Jie,Huo, Fengmin,Ma, Yifeng,Zhao, Liping...&Huang, Hairong.(2017).Prevalence and treatment outcome of extensively drug-resistant tuberculosis plus additional drug resistance from the National Clinical Center for Tuberculosis in China: A five-year review.JOURNAL OF INFECTION,75,(5)
MLA:
Pang, Yu,et al."Prevalence and treatment outcome of extensively drug-resistant tuberculosis plus additional drug resistance from the National Clinical Center for Tuberculosis in China: A five-year review".JOURNAL OF INFECTION 75..5(2017):433-440