Impact of pyrazinamide resistance on multidrug-resistant tuberculosis in Karakalpakstan, Uzbekistan
| Autor: | David Moore, Chris Smith, Zinaida Tigay, Mirzagaleb N. Tillyashaykhov, Atadjan Khaemraev, Johanna Kuhlin, P. du Cros, J Hajek, Jane Greig, Jay Achar, Nargiza Parpieva |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis 030106 microbiology Antitubercular Agents Microbial Sensitivity Tests Drug resistance Young Adult 03 medical and health sciences 0302 clinical medicine Drug Resistance Multiple Bacterial Internal medicine Tuberculosis Multidrug-Resistant Humans Medicine 030212 general & internal medicine Young adult Retrospective Studies business.industry Retrospective cohort study Mycobacterium tuberculosis Uzbekistan Odds ratio Pyrazinamide medicine.disease Regimen Logistic Models Treatment Outcome Infectious Diseases Multivariate Analysis Female business medicine.drug Cohort study |
| Zdroj: | The International Journal of Tuberculosis and Lung Disease. 22:544-550 |
| ISSN: | 1027-3719 2003-2013 |
| DOI: | 10.5588/ijtld.17.0483 |
| Popis: | SETTING: The World Health Organization (WHO) recommends the inclusion of pyrazinamide (PZA) in treatment regimens for multidrug-resistant tuberculosis (MDR-TB) unless resistance has been confirmed. OBJECTIVE: To investigate the association between PZA susceptibility and MDR-TB treatment outcome among patients treated with a PZA-containing regimen and whether the duration of the intensive phase of the PZA-containing regimen affected treatment outcome. DESIGN: We conducted a retrospective cohort study including all eligible MDR-TB patients starting treatment in 2003-2013 in the TB programme in Karakalpakstan, Uzbekistan. PZA drug susceptibility testing (DST) using liquid culture was performed, and outcomes were classified according to the WHO 2013 definitions. RESULTS: Of 2446 MDR-TB patients included, 832 (34.0%) had an available baseline PZA DST result, 612 (73.6%) of whom were PZA-resistant. We found no association between treatment success and PZA susceptibility (adjusted odds ratio [aOR] 0.86, 95%CI 0.51-1.44, P = 0.6) in patients treated with PZA. Furthermore, among patients with no baseline PZA DST result, no evidence was seen of an association between treatment success and PZA treatment duration (aOR 0.86, 95%CI 0.49-1.51, P = 0.6). CONCLUSION: Treatment of MDR-TB with a standard PZA regimen does not appear to improve treatment outcomes, regardless of PZA susceptibility or duration of treatment. |
| Databáze: | OpenAIRE |
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