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Survival and predictors of outcomes in non-HIV-infected patients with extensively drug-resistant tuberculosis.

AbstractSETTING:
A tuberculosis (TB) referral hospital in South Korea.
OBJECTIVE:
To evaluate predictors of treatment outcomes and survival among non-human immunodeficiency virus (HIV) infected patients with extensively drug-resistant TB (XDR-TB).
DESIGN:
Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. We conducted a retrospective review of their medical records and mortality data.
RESULTS:
A total of 176 non-HIV-infected patients with XDR-TB were included. TB-related mortality was 48% (84/176), and the median survival time from the diagnosis date of XDR-TB was 51 months (range 0-127, 95%CI 32.53-69.47). Cure and treatment completion were classified as favourable outcome and treatment failure, death during treatment and default as poor outcome. Previous TB treatment with second-line drugs (aOR 2.76, 95%CI 1.02-7.44) and cavitary disease (aOR 3.01, 95%CI 1.12-8.08) were independent risk factors for poor outcome. Use of linezolid (aOR 0.10, 95%CI 0.01-0.69) and surgical resection (aOR 0.18, 95%CI 0.04-0.78) were associated with favourable outcome.
CONCLUSION:
There was high mortality in non-HIV-infected patients with XDR-TB at a TB referral hospital in South Korea. Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB.
AuthorsD S Jeon, D H Kim, H S Kang, S H Hwang, J H Min, J H Kim, N M Sung, M W Carroll, S K Park
JournalThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 13 Issue 5 Pg. 594-600 (May 2009) ISSN: 1027-3719 [Print] France
PMID19383192 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Antitubercular Agents
Topics
  • Adult
  • Antitubercular Agents (therapeutic use)
  • Extensively Drug-Resistant Tuberculosis (mortality, therapy)
  • Female
  • Follow-Up Studies
  • HIV Infections
  • Hospitals, Special (statistics & numerical data)
  • Humans
  • Korea (epidemiology)
  • Male
  • Pneumonectomy (methods)
  • Retrospective Studies
  • Survival Rate (trends)
  • Treatment Outcome

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