title: Management of pediatric multidrug-resistant tuberculosis and latent tuberculosis infections in New York City from 1995 to 2003.
abstract: BACKGROUND
  Few studies have assessed the management and outcomes of multidrug-resistant tuberculosis (MDR-TB) in the pediatric population. Treatment of children with second-line TB drugs is complicated by potential toxicities of these agents.
  
  
  METHODS
  We performed a retrospective study of children <15 years of age treated for MDR-TB or MDR-latent TB infection (LTBI) from 1995 to 2003. We reviewed the New York City Department of Health and Mental Hygiene (DOHMH) computerized TB registry to characterize demographic characteristics, clinical presentations, treatment, and outcomes of the study subjects.
  
  
  RESULTS
  Twenty subjects with MDR-TB (mean age 2.7 years) and 51 with MDR-LTBI (mean age 9.8 years) were studied. The most commonly used second-line TB drugs were cycloserine, quinolone agents, and ethionamide, which were used in 70%, 69%, and 54% of subjects, respectively. Sixteen (80%) of 20 MDR-TB and 38 (75%) of 51 MDR-LTBI cases completed treatment. A greater proportion of subjects receiving care at a DOH clinic completed treatment for LTBI (36/41, 88%), when compared with subjects treated at non-DOH sites [(2/9, 22%) P < 0.001]. Review of the TB registry indicated that no subjects had recurrent disease or progression of LTBI to active disease during the study period and for 2 years thereafter.
  
  
  CONCLUSIONS
  Children with MDR-TB and LTBI were best cared for in public health settings. A multicenter registry for pediatric MDR-TB and MDR-LTBI would be desirable to obtain accurate rates of toxicity and cure.
authors.affiliation: Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ 08901, USA. kfeja@saintpetersuh.com
authors.forename: Kristina
authors.initials: K
authors.lastname: Feja
authors.forename: Erin
authors.initials: E
authors.lastname: McNelley
authors.forename: Cindy S
authors.initials: CS
authors.lastname: Tran
authors.forename: Joseph
authors.initials: J
authors.lastname: Burzynski
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman