title: Clinical outcomes of Estonian patients with primary multidrug-resistant versus drug-susceptible tuberculosis.
abstract: Little is known about the clinical outcomes of patients with primary multidrug-resistant (MDR) tuberculosis. Clinical outcomes among 46 patients in Estonia with primary MDR tuberculosis and 46 patients with pansusceptible tuberculosis were compared. Patients with MDR tuberculosis were more likely than those with pansensitive tuberculosis to have treatment failure (odds ratio, 8.9; 95% confidence interval [CI], 3.0-26.3) after adjusting for medical problems and weeks of effective treatment, often with second-line drugs. Ten patients (22%) with MDR tuberculosis and 2 (4%) with susceptible tuberculosis died of tuberculosis (P=.03). MDR tuberculosis (hazard ratio [HR], 7.8; 95% CI, 1.6-37.4), number of medical problems (HR, 2.5; 95% CI, 1.5-4.4), and male sex (HR, 5.8; 95% CI, 1.1-29.6) were associated with death due to tuberculosis in multivariable analysis. Human immunodeficiency virus test results were negative for all 55 patients tested. These findings underscore the urgent need for increased attention to prevention and treatment of MDR tuberculosis globally.
authors.affiliation: Division of Tuberculosis Elimination, National Centers for HIV/AIDS, STD, and TB Prevention, and Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Lockman
authors.forename: A
authors.initials: A
authors.lastname: Kruuner
authors.forename: N
authors.initials: N
authors.lastname: Binkin
authors.forename: K
authors.initials: K
authors.lastname: Levina
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Danilovitsh
authors.forename: S
authors.initials: S
authors.lastname: Hoffner
authors.forename: J
authors.initials: J
authors.lastname: Tappero
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D024901:Drug Resistance, Multiple, Bacterial; D004957:Estonia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D017211:Treatment Failure; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents