title: Highly successful treatment outcome of multidrug-resistant tuberculosis in the Netherlands, 2000-2009.
abstract: METHODS
  Resistance to the two key anti-tuberculosis drugs isoniazid and rifampicin is a characteristic of multidrug-resistant tuberculosis (MDR-TB). MDR-TB is a scourge requiring toxic, prolonged treatment and is associated with poor outcomes. The Netherlands is a country with a long-standing, integrated, well-resourced TB service where all patients are offered culture-confirmed diagnosis by a central reference laboratory.
  
  
  OBJECTIVE
  To assess the treatment outcomes of MDR-TB patients over a period of 10 years in The Netherlands.
  
  
  METHODS
  Demographic, clinical and microbiological features of all patients with MDR-TB who started treatment in 2000-2009 in the Netherlands were analysed from national registry and patient records.
  
  
  RESULTS
  Characteristics of the 113 MDR-TB patients were as follows: male/female ratio 1.57, 96% foreign born, median age 29 years, 96 (85%) pulmonary TB, 56 (50%) smear-positive, 14 (12%) human immunodeficiency virus (HIV) co-infected. Of the 104 (92%) patients who started MDR-TB treatment, 86% had a successful outcome using a median of six active drugs; eight underwent pulmonary surgery. HIV negativity was associated with successful outcome (adjusted OR 2.1, 95%CI 1.1-3.8).
  
  
  CONCLUSIONS
  High success rates for MDR-TB treatment were achieved with close collaboration of all stakeholders, reaching the targets set for drug-susceptible TB. HIV remained an independent risk factor for unsuccessful treatment outcome.
authors: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands.
authors: R
authors: R
authors: van Altena
authors: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Centre for Infectious Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
authors: G
authors: G
authors: de Vries
authors: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands.
authors: C H
authors: CH
authors: Haar
authors: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands.
authors: W C M
authors: WC
authors: de Lange
authors: Tuberculosis Center, University Center for Chronic Diseases Dekkerswald, Radboud Nijmegen University Medical Center, Nijmegen, The Netherlands.
authors: C
authors: C
authors: Magis-Escurra
authors: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors: S
authors: S
authors: van den Hof
authors: Tuberculosis Reference Laboratory, Centre for Infectious Diseases, National Institute for Health and the Environment (RIVM), Bilthoven, The Netherlands; Departments of Medical Microbiology and Lung Disease, Radboud Nijmegen University Medical Center, Nijmegen, The Netherlands.
authors: D
authors: D
authors: van Soolingen
authors: Tuberculosis Center, University Center for Chronic Diseases Dekkerswald, Radboud Nijmegen University Medical Center, Nijmegen, The Netherlands.
authors: M J
authors: MJ
authors: Boeree
authors: Tuberculosis Center Beatrixoord, University Medical Center Groningen, Department of Pulmonary Medicine & Tuberculosis, University of Groningen, Haren, The Netherlands; University Medical Center Groningen, Department of Internal Medicine, Infectious Diseases, University of Groningen, The Netherlands.
authors: T S
authors: TS
authors: van der Werf
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000628:therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents