title: Drug-resistant tuberculosis in children in Thailand.
abstract: METHODS
  Few data on drug-resistant (DR) tuberculosis (TB) in children are available in Thailand.
  
  
  OBJECTIVE
  To evaluate the rate, clinical features and risk of DR-TB in children.
  
  
  METHODS
  Observational prospective study conducted in children diagnosed with TB at a tertiary care centre in Bangkok.
  
  
  RESULTS
  Of 230 children diagnosed with TB, the median age was 6.5 years; 63% had identified adult source cases, and only 7% had received prior isoniazid treatment for latent tuberculous infection. Of the 195 (85%) specimens submitted, 57 (25%) were positive using culture or polymerase chain reaction. Of the 53 positive specimens available for drug susceptibility testing (DST), 18 (34%) had any resistance, 13 (24.5%) were mono-resistant, 2 (3.8%) polyresistant and 3 (5.7%) were multidrug-resistant. In multivariate analysis, prior TB treatment (P < 0.001), presence of atelectasis (P = 0.039) or lobar consolidation (P = 0.012) on chest X-ray were associated with DR-TB. DR-TB required longer treatment but there were no differences in rate of cure, treatment completion or death.
  
  
  CONCLUSIONS
  The high rate of DR-TB underscores the importance of routine DST. History of treatment and drug susceptibility in source cases was useful in guiding initial treatment in children.
authors.affiliation: Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Lapphra
authors.forename: C
authors.initials: C
authors.lastname: Sutthipong
authors.forename: S
authors.initials: S
authors.lastname: Foongladda
authors.forename: N
authors.initials: N
authors.lastname: Vanprapar
authors.forename: W
authors.initials: W
authors.lastname: Phongsamart
authors.forename: O
authors.initials: O
authors.lastname: Wittawatmongkol
authors.forename: R
authors.initials: R
authors.lastname: Saksawad
authors.forename: K
authors.initials: K
authors.lastname: Chokephaibulkit
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012306:Risk; D062606:Tertiary Care Centers; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid