Factors associated with multidrug-resistant tuberculosis: comparison of patients born inside and outside of the Czech Republic.
Multidrug-resistant tuberculosis (MDR-TB) is defined as resistance of Mycobacterium tuberculosis complex (MTB) to at least isoniazid and rifampicin. The aim of this study was to evaluate and compare a cohort of 50 patients with MDR-TB according to birthplace, resistance type, clinical outcome, length of bacteriological positivity of sputum and length of hospitalization. Thirty-three of the patients were born in the Czech Republic (group A) and 17 were immigrants to the Czech Republic (group B). Patients in group B were significantly younger (mean [range] age 33 [19 - 56] years) than those in group A (mean [range] age 48 [33 - 80] years). Primary resistance was present in 16 (48%) cases in group A and in 13 (76%) cases in group B. There were 36 (72%) cured patients, five (10%) remained on treatment and nine (18%) died; no patients failed or transferred out of the study. The mean length of bacteriological positivity of sputum samples was 5.9 months and the mean length of hospitalization was 8.2 months. Resistance to capreomycin was an important predictor of poor outcome.
Bartu
V
V
Department of Respiratory Diseases, Medicon, Prague, Czech Republic. vaclava.bartu@mediconas.cz
Kopecka
E
E
Havelkova
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D018153:Czech Republic / Q000453:epidemiology; D004359:Drug Therapy, Combination; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D015996:Survival Rate; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D000995:Antitubercular Agents