Multidrug- and extensively drug-resistant tuberculosis, Germany.
We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004-2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean +/- SD 202 +/- 130 vs. 123 +/- 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB.
Eker
Barbara
B
Research Center Borstel, Borstel, Germany.
Ortmann
Johannes
J
Migliori
Giovanni B
GB
Sotgiu
Giovanni
G
Muetterlein
Ralf
R
Centis
Rosella
R
Hoffmann
Harald
H
Kirsten
Detlef
D
Schaberg
Tom
T
Ruesch-Gerdes
Sabine
S
Lange
Christoph
C
D000081:Acetamides / Q000627:therapeutic use; D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D024901:Drug Resistance, Multiple, Bacterial; D054242:Emigrants and Immigrants; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D000069349:Linezolid; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D023303:Oxazolidinones / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology
D000081:Acetamides; D000995:Antitubercular Agents; D023303:Oxazolidinones; D000069349:Linezolid