Survival and predictors of outcomes in non-HIV-infected patients with extensively drug-resistant tuberculosis.
METHODS
A tuberculosis (TB) referral hospital in South Korea.


OBJECTIVE
To evaluate predictors of treatment outcomes and survival among non-human immunodeficiency virus (HIV) infected patients with extensively drug-resistant TB (XDR-TB).


METHODS
Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. We conducted a retrospective review of their medical records and mortality data.


RESULTS
A total of 176 non-HIV-infected patients with XDR-TB were included. TB-related mortality was 48% (84/176), and the median survival time from the diagnosis date of XDR-TB was 51 months (range 0-127, 95%CI 32.53-69.47). Cure and treatment completion were classified as favourable outcome and treatment failure, death during treatment and default as poor outcome. Previous TB treatment with second-line drugs (aOR 2.76, 95%CI 1.02-7.44) and cavitary disease (aOR 3.01, 95%CI 1.12-8.08) were independent risk factors for poor outcome. Use of linezolid (aOR 0.10, 95%CI 0.01-0.69) and surgical resection (aOR 0.18, 95%CI 0.04-0.78) were associated with favourable outcome.


CONCLUSIONS
There was high mortality in non-HIV-infected patients with XDR-TB at a TB referral hospital in South Korea. Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB.
Jeon
D S
DS
National Masan Tuberculosis Hospital, Masan, South Korea; and International Tuberculosis Research Center, Masan, South Korea. sooli10kr@yahoo.co.kr
Kim
D H
DH
Kang
H S
HS
Hwang
S H
SH
Min
J H
JH
Kim
J H
JH
Sung
N M
NM
Carroll
M W
MW
Park
S K
SK
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D054908:Extensively Drug-Resistant Tuberculosis / Q000401:mortality* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
D000995:Antitubercular Agents