Survival of Civilian and Prisoner Drug-Sensitive, Multi- and Extensive Drug- Resistant Tuberculosis Cohorts Prospectively Followed in Russia

Autor: Balabanova, Y, Nikolayevskyy, V, Ignatyeva, O, Kontsevaya, I, Rutterford, CM, Shakhmistova, A, Malomanova, N, Chinkova, Y, Mironova, S, Fedorin, I, Drobniewski, FA
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Bacterial Diseases
Male
Time Factors
Epidemiology
Extensively Drug-Resistant Tuberculosis
lcsh:Medicine
Kaplan-Meier Estimate
Global Health
Russia
0302 clinical medicine
Risk Factors
Drug Resistance
Multiple
Bacterial
Medicine
Clinical Epidemiology
030212 general & internal medicine
Prospective Studies
lcsh:Science
Prospective cohort study
0303 health sciences
Molecular Epidemiology
Multidisciplinary
biology
Multi-Drug-Resistant Tuberculosis
Middle Aged
3. Good health
HIV epidemiology
Cohort
Infectious diseases
Female
Public Health
Research Article
Adult
medicine.medical_specialty
Tuberculosis
Genotype
Viral diseases
Infectious Disease Epidemiology
Mycobacterium tuberculosis
03 medical and health sciences
Antibiotic resistance
Internal medicine
Humans
Demography
Proportional Hazards Models
030306 microbiology
business.industry
Proportional hazards model
Prisoners
lcsh:R
Extensively drug-resistant tuberculosis
HIV
medicine.disease
biology.organism_classification
Surgery
Multivariate Analysis
Mutation
lcsh:Q
business
Zdroj: PLoS ONE
PLoS ONE; Vol 6
PLoS ONE, Vol 6, Iss 6, p e20531 (2011)
ISSN: 1932-6203
Popis: Objective and Methods: A long-term observational study was conducted in Samara, Russia to assess the survival and risk factors for death of a cohort of non-multidrug resistant tuberculosis (non-MDRTB) and multidrug resistant tuberculosis (MDRTB) civilian and prison patients and a civilian extensive drug-resistant tuberculosis (XDRTB) cohort. Results: MDRTB and XDRTB rates of 54.8% and 11.1% were identified in the region. Half (50%) of MDRTB patients and the majority of non-MDRTB patients (71%) were still alive at 5 years. Over half (58%) of the patients died within two years of establishing a diagnosis of XDRTB. In the multivariate analysis, retreatment (HR = 1.61, 95%CI 1.04, 2.49) and MDRTB (HR = 1.67, 95%CI 1.17, 2.39) were significantly associated with death within the non-MDR/MDRTB cohort. The effect of age on survival was relatively small (HR = 1.01, 95%CI 1.00, 1.02). No specific factor affected survival of XDRTB patients although median survival time for HIV-infected versus HIV-negative patients from this group was shorter (185 versus 496 days). The majority of MDRTB and XDRTB strains (84% and 92% respectively) strains belonged to the Beijing family. Mutations in the rpoB (codon 531 in 81/92; 88.8%), katG (mutation S315T in 91/92, 98.9%) and inhA genes accounted for most rifampin and isoniazid resistance respectively, mutations in the QRDR region of gyrA for most fluroquinolone resistance (68/92; 73.5%). Conclusions: Alarmingly high rates of XDRTB exist. Previous TB treatment cycles and MDR were significant risk factors for mortality. XDRTB patients survival is short especially for HIV-infected patients. Beijing family strains comprise the majority of drug-resistant strains. © 2011 Balabanova et al.
Databáze: OpenAIRE
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