title: Determination of risk factors for isoniazid monoresistance and multidrug-resistant tuberculosis in treatment failure patients.
abstract: India has a high number of drug-resistant tuberculosis cases. Patient records were screened to determine risk factors possibly associated with monoresistance and multidrug-resistant tuberculosis (MDR-TB) in comparison with patients with susceptible TB. We retrospectively screened and selected 250 patient records from a tertiary care centre, in which detailed clinical histories were provided. Of the 250 patients, 10 had isoniazid monoresistant TB, 184 patients had MDR-TB, and 56 patients had TB susceptible to first-line drugs. Binary regression analysis revealed that previous treatment with a fluoroquinolone and an injectable other than streptomycin (odds ratio (OR) 3.889, 95% confidence interval (CI) 1.828-8.272) was associated with MDR-TB. Previous history of TB (OR 0.697, 95% CI 0.363-1.338) and the presence of cavities on radiographs (OR 0.371, 95% CI 0.160-0.862) did not show any association. None of these reported risk factors were associated with isoniazid monoresistance. In conclusion, a history of previous treatment with a fluoroquinolone and an injectable other than streptomycin was found to be a risk factor for MDR-TB.
authors.affiliation: P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India.
authors.forename: Viral
authors.initials: V
authors.lastname: Vadwai
authors.forename: Anjali
authors.initials: A
authors.lastname: Shetty
authors.forename: Rajeev
authors.initials: R
authors.lastname: Soman
authors.forename: Camilla
authors.initials: C
authors.lastname: Rodrigues
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D007194:India / Q000453:epidemiology; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones; D007538:Isoniazid