Prevalence and risk factors for drug resistance among hospitalized tuberculosis patients in Georgia.
BACKGROUND
Tuberculosis (TB) control in Georgia follows the World Health Organization-recommended DOTS strategy, and has reached global TB control targets in the treatment of susceptible TB; however, the management of drug-resistant forms of TB still represents a serious problem. A countrywide drug resistance survey (DRS) found that the prevalence of multidrug-resistant TB (MDR-TB) was respectively 6.8% and 27.4% in new and previously treated TB cases.


OBJECTIVE
To determine the prevalence of and risk factors for drug resistance among TB patients to improve case management and control of drug-resistant TB.


METHODS
Extensive social, clinical and bacteriological data were collected from patients hospitalized at the National Centre for Tuberculosis and Lung Diseases, Georgia, between 2005 and 2007.


RESULTS
Of 605 patients, resistance was observed in 491 (81.2%); MDR-TB was found in 261 (43.1%; 51/222 [23%] new cases and 210/383 [55%] previously treated cases), monoresistant TB in 130 (21.5%), poly-resistant TB in 67 (11.1%) and extensively drug-resistant TB in 33 (5.5%). Female sex, living in the densely populated capital, family TB contact and previous TB treatment were associated with risk of MDR-TB.


CONCLUSIONS
These findings confirm the necessity of improving infection control measures and of standardized treatment for drug-resistant TB patients.
Vashakidze
L
L
National Centre for Tuberculosis and Lung Diseases, Tbilisi, Georgia.
Salakaia
A
A
Shubladze
N
N
Cynamon
M
M
Barbakadze
K
K
Kikvidze
M
M
Papitashvili
L
L
Nonikashvili
M
M
Solomonia
N
N
Bejanishvili
N
N
Khurtsilava
I
I
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D017053:Infection Control; D007297:Inpatients / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016017:Odds Ratio; D011156:Population Density; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D014505:Urban Population
D000995:Antitubercular Agents