Clinical and genetic risk factors for the development of multi-drug resistant tuberculosis in non-HIV infected patients at a tertiary care center in India: a case-control study

Sharma, Surendra Kumar; Turaga, Kiran K.; Balamurugan, Arumugam; Saha, Pradip Kumar; Pandey, RM; Jain, Nilesh; Katoch, V. M.; Nk, Mehra

doi:10.1016/s1567-1348(03)00086-8

Cited by 61 publications

(39 citation statements)

References 19 publications

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“…In agreement with previous studies, we found that MDR TB at baseline was associated with a history of treatment failure [2,29], an increased number of previous TB episodes [30], and the presence of cavities on chest radiograph [31]. In the human lung, the selection of drug-resistance mutations in M. tuberculosis occurs predominantly within cavities, a site of high bacterial loads, active mycobacterial replication, reduced levels of anti-TB drugs, and diminished exposure to host defense mechanisms [32,33].…”

Section: Discussionmentioning

confidence: 92%

Rate and Amplification of Drug Resistance among Previously‐Treated Patients with Tuberculosis in Kampala, Uganda

et al. 2008

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Section: Discussionmentioning

confidence: 92%

Rate and Amplification of Drug Resistance among Previously‐Treated Patients with Tuberculosis in Kampala, Uganda

et al. 2008

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“…Lack of adequate healthcare facilities, inappropriate/poor working conditions, and poor housing conditions are believed to be major factors contributing to an increase in the prevalence of drug resistance within the immigrant population. The risk of resistance to anti-TB drugs was reported to be threefold to tenfold higher in immigrants than in the local population, and 17% of TB cases among the immigrants were MDR-TB [27][28][29][30][31]. In the present study, a fivefold higher risk of resistance to anti-TB drugs in immigrants was reported, which is similar to that found in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Previous history of anti-tuberculosis treatment was most commonly reported as a significant risk factor in the development of MDR-TB [4,28,29]. This may indicate that acquired drug resistance could be a result of previous non-compliance.…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

Elmi

Hasan

Abdullah

et al. 2015

J Infect Dev Ctries

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Introduction: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia. Methodology: This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls. Results: A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear. Conclusions: The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.

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“…Previous studies identified some risk factors associated with MDR-TB, namely previous TB treatment [8], [9], [10], [11], [12], poor past compliance with treatment [12], [13], HIV infection [9], [14], younger age-group [9], [15], [16], gender [9], [13], foreign born people [9], [16], living in an urban area [15], working in health care [14], type by bacteriology and pulmonary site of TB [14], presence of cavitation in lungs [12], contact with a TB patient [11], smoking or other substance misuse [14], [17], [18], chronic renal failure [19], diabetes [20], use of other anti-microbial medicine [19], being an asylum seeker [14], living in a nursing home [14], being a prisoner [14], and hospitalization history [21]. Inappropriate medical management, absence of directly observed treatment, lack of uniformity between public and private sectors, limited or interrupted drug supply, poor quality and widespread availability of anti-tuberculosis drugs, were also reported as important causes associated with MDR-TB [10], [22], [23].…”

Section: Introductionmentioning

confidence: 99%

Development of Multidrug Resistant Tuberculosis in Bangladesh: A Case-Control Study on Risk Factors

et al. 2014

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ObjectiveTo determine the risk factors for developing multidrug resistant tuberculosis in Bangladesh.MethodsThis case-control study was set in central, district and sub-district level hospitals of rural and urban Bangladesh. Included were 250 multidrug resistant tuberculosis (MDR-TB) patients as cases and 750 drug susceptible tuberculosis patients as controls. We recruited cases from all three government hospitals treating MDR-TB in Bangladesh during the study period. Controls were selected randomly from those local treatment units that had referred the cases. Information was collected through face-to-face interviews and record reviews. Unadjusted and multivariable logistic regression were used to analyse the data.ResultsPrevious treatment history was shown to be the major contributing factor to MDR-TB in univariate analysis. After adjusting for other factors in multivariable analysis, age group “18–25” (OR 1.77, CI 1.07–2.93) and “26–45” (OR 1.72, CI 1.12–2.66), some level of education (OR 1.94, CI 1.32–2.85), service and business as occupation (OR 2.88, CI 1.29–6.44; OR 3.71, CI 1.59–8.66, respectively), smoking history (OR 1.58, CI 0.99–2.5), and type 2 diabetes (OR 2.56 CI 1.51–4.34) were associated with MDR-TB. Previous treatment was not included in the multivariable analysis as it was correlated with multiple predictors.ConclusionPrevious tuberculosis treatment was found to be the major risk factor for MDR-TB. This study also identified age 18 to 45 years, some education up to secondary level, service and business as occupation, past smoking status, and type 2 diabetes as comorbid illness as risk factors. National Tuberculosis programme should address these risk factors in MDR-TB control strategy. The integration of MDR-TB control activities with diabetes and tobacco control programmes is needed in Bangladesh.

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Clinical and genetic risk factors for the development of multi-drug resistant tuberculosis in non-HIV infected patients at a tertiary care center in India: a case-control study

Cited by 61 publications

References 19 publications

Rate and Amplification of Drug Resistance among Previously‐Treated Patients with Tuberculosis in Kampala, Uganda

Rate and Amplification of Drug Resistance among Previously‐Treated Patients with Tuberculosis in Kampala, Uganda

Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study

Development of Multidrug Resistant Tuberculosis in Bangladesh: A Case-Control Study on Risk Factors

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