Resistance to Second-Line Antituberculosis Drugs and Delay in Drug Susceptibility Testing among Multidrug-Resistant Tuberculosis Patients in Shanghai
| Autor: | Zheyuan Wu, Yong Chen, Biao Xu, Jie Wu, Zhengan Yuan, Xin Shen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty China Tuberculosis Capreomycin Article Subject 030106 microbiology Antitubercular Agents lcsh:Medicine Microbial Sensitivity Tests General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Second line Internal medicine Total delay Drug Resistance Bacterial Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine Retrospective Studies General Immunology and Microbiology business.industry lcsh:R General Medicine Drug susceptibility Mycobacterium tuberculosis Middle Aged medicine.disease Surgery Multiple drug resistance Amikacin Female Ofloxacin business medicine.drug Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2016 (2016) |
| ISSN: | 2314-6141 2314-6133 |
| Popis: | Introduction. Second-line antituberculosis drugs (SLDs) are used for treating multidrug-resistant tuberculosis (MDR-TB). Prolonged delays before confirming MDR-TB with drug susceptibility testing (DST) could result in transmission of drug-resistant strains and inappropriate use of SLDs, thereby increasing the risk of resistance to SLDs. This study investigated the diagnostic delay in DST and prevalence of baseline SLD resistance in Shanghai and described the distribution of SLD resistance with varied delays to DST.Methods. All registered patients from 2011 to 2013 in Shanghai were enrolled. Susceptibility to ofloxacin, amikacin, kanamycin, and capreomycin was tested. Total delay in DST completion was measured from the onset of symptoms to reporting DST results.Results. Resistance to SLDs was tested in 217 of the 276 MDR-TB strains, with 118 (54.4%) being resistant to at least one of the four SLDs. The median total delay in DST was 136 days. Patients with delay longer than median days were roughly twice more likely to have resistance to at least one SLD (OR 2.22, 95% CI 1.19–4.11).Conclusions. During prolonged delay in DST, primary and acquired resistance to SLDs might occur more frequently. Rapid diagnosis of MDR-TB, improved nosocomial infection controls, and regulated treatment are imperative to prevent SLD resistance. |
| Databáze: | OpenAIRE |
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