Clinical features and outcomes of isoniazid mono-resistant pulmonary tuberculosis.
OBJECTIVE
To determine the characteristics of pulmonary tuberculosis (TB) patients harbored organisms with isoniazid mono-resistant drug susceptibility pattern.


METHODS
A retrospective review of medical records for all culture-proven adult pulmonary TB patients in Siriraj Hospital between July 2009 and July 2011 was conducted. Demographic data, clinical presentations, and radiological characteristics were recorded and compared between isoniazid mono-resistant and other-resistant groups. Treatment regimens with outcome determination of patients infected with isoniazid mono-resistant strains were also verified.


RESULTS
Among 489 patients during the present study period, 28 were infected with isoniazid mono-resistant strain (5.7%). The mean age was 53 +/- 18 years, and 8% of them had a history of previous treatment in the past. When compared with those infected with any other form of resistant strains, isoniazid mono-resistant pulmonary TB patients tended to have less radiographic cavitary lesion (8.3% vs. 26.7%, p = 0.006) but no significant difference was seen in term of demographic data and clinical presentations. All of them who had completed the treatment were cured. No difference in cure rate and relapse rate among patients treated with quinolone or non-quinolone containing regimens.


CONCLUSIONS
Isoniazid mono-resistance shares common clinical features with other resistances pulmonary TB, except for less cavitary lesion from initial chest radiograph. Appropriate drug susceptibility testing with prompt regimen adjustment can lead to a favorable treatment outcome.
Nitipatana
N
Chierakul
Vorachai
V
Saengthongpinij
Suporn
S
Foongladda
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents; D007538:Isoniazid