title: Risk factors for acquisition of drug resistance during multidrug-resistant tuberculosis treatment, Arkhangelsk Oblast, Russia, 2005-2010.
abstract: Acquired resistance to antituberculosis drugs decreases effective treatment options and the likelihood of treatment success. We identified risk factors for acquisition of drug resistance during treatment for multidrug-resistant tuberculosis (MDR TB) and evaluated the effect on treatment outcomes. Data were collected prospectively from adults from Arkhangelsk Oblast, Russia, who had pulmonary MDR TB during 2005-2008. Acquisition of resistance to capreomycin and of extensively drug-resistant TB were more likely among patients who received <3 effective drugs than among patients who received >3 effective drugs (9.4% vs. 0% and 8.6% vs. 0.8%, respectively). Poor outcomes were more likely among patients with acquired capreomycin resistance (100% vs. 25.9%), acquired ofloxacin resistance (83.6% vs. 22.7%), or acquired extensive drug resistance (100% vs. 24.4%). To prevent acquired drug resistance and poor outcomes, baseline susceptibility to first- and second-line drugs should be determined quickly, and treatment should be adjusted to contain >3 effective drugs.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Smith
authors.forename: Julia
authors.initials: J
authors.lastname: Ershova
authors.forename: Natalia
authors.initials: N
authors.lastname: Vlasova
authors.forename: Elena
authors.initials: E
authors.lastname: Nikishova
authors.forename: Irina
authors.initials: I
authors.lastname: Tarasova
authors.forename: Platon
authors.initials: P
authors.lastname: Eliseev
authors.forename: Andrey O
authors.initials: AO
authors.lastname: Maryandyshev
authors.forename: Igor G
authors.initials: IG
authors.lastname: Shemyakin
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Kurbatova
authors.forename: J Peter
authors.initials: JP
authors.lastname: Cegielski
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015331:Cohort Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Russia; acquired drug resistance; antimicrobial resistance; bacteria; risk factors; tuberculosis and other mycobacteria