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Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China.

Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China.
Author Information (click to view)

He XC, Tao NN, Liu Y, Zhang XX, Li HC,


He XC, Tao NN, Liu Y, Zhang XX, Li HC, (click to view)

He XC, Tao NN, Liu Y, Zhang XX, Li HC,

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BMC infectious diseases 2017 08 0917(1) 555 doi 10.1186/s12879-017-2652-x

Abstract
BACKGROUND
Extensively Drug-Resistant (XDR) Tuberculosis (TB) has posed a great threat to global health and finance systems, especially for developing countries with high TB and Multidrug-Resistant (MDR) TB burden.

METHODS
We retrospectively analyzed HIV-uninfected TB case confirmed and treated in Shandong Provincial Chest Hospital (SPCH) between January 2008 and December 2015. Unique characteristics of XDR-TB were identified; its longitudinal changes and survival were analyzed.

RESULTS
Between January 2008 and December 2015, a total of 144 cases were confirmed to be XDR-TB (2.5% of 5663 culture-confirmed TB cases; 27.9% of 516 MDR-TB cases). The proportion of XDR TB cases among MDR-TB cases has increased from 26.5% in 2008 to 44.5% in 2014 (Chi-Square test for trends: P < 0.01). Among the 144 XDR-TB cases, 21 patients (14.6%) had treatment success, 123 (85.1%) had poor treatment outcomes. Mortality was higher among XDR-TB cases than among MDR TB cases (8.3% vs. 3.8%, P = 0.033) and drug-susceptible TB cases (8.3% vs. 2.1%, P < 0.01). CONCLUSIONS
XDR-TB cases comprise a substantial and increasing fraction of MDR-TB cases, causing poor treatment outcomes and high mortalities. Early drug susceptibility testing, adequate TB treatment and efficient infection control must be in place in future TB control strategies.

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