Risk factors associated with kanamycin-resistant tuberculosis in a Beijing tuberculosis referral hospital

Abstract

The rapidly increasing number of multidrug-resistant tuberculosis (MDR-TB) cases worldwide underlines the necessity for the rational use of key second-line drugs such as kanamycin. In this study, we determined the prevalence of, and risk factors associated with, kanamycin-resistant tuberculosis (TB) in 309 Hospital, Beijing, China, with the aim of providing information for better case management in order to minimize further development of extensively drug-resistant TB (XDR-TB). Drug susceptibility testing results and clinical data were retrospectively analysed for hospitalized TB patients for whom such data were available in 309 Hospital for the period 1997-2009. Univariate and multivariate analyses were used to determine the risk factors associated with kanamycin-resistant TB. During 1997During -20094 %) of 3843 tested Mycobacterium tuberculosis isolates from hospitalized TB patients were kanamycin-resistant. The increasing trend of resistance to kanamycin was reversed since 2000. The independent risk factors associated with kanamycin-resistant TB included living in urban areas [adjusted odds ratio (OR)51.89], being retreated for repeat cases (adjusted OR51.60), being smear-positive for acid-fast bacilli at admission to the hospital (adjusted OR51.39), having ofloxacin-resistant (adjusted OR51.61) or para-aminosalicylic acid-resistant TB (adjusted OR51.47), having MDR-TB (adjusted OR55.10), having MDR-TB plus ofloxacin resistance (adjusted OR54.27) and having poly-resistant TB (adjusted OR53.94). The remaining rate of kanamycin resistance is still high despite the reversal of the increasing trend during the past decade. Surveillance of kanamycin resistance, especially among high-risk populations, should be continued to closely monitor trends so that appropriate action can be taken.

Levofloxacin‐containing Triple and Sequential Therapy or Standard Sequential Therapy as the First Line Treatment for Helicobacter pylori Eradication in China

“…In China, the primary resistance rates to levofloxacin in H . pylori range from 0 to 41.7%, which are lower than that for metronidazole and clarithromycin .…”

“…In addition, whether levofloxacin performs equally or better in a sequential regimen has not been evaluated. In China, the primary resistance rates to levofloxacin in H. pylori range from 0 to 41.7%, which are lower than that for metronidazole and clarithromycin [12,[27][28][29][30][31][32][33][34][35][36][37]. Therefore, the present multicenter, randomized and controlled study was designed and conducted to compare the eradication rates as well as the adverse effects of a levofloxacin-containing triple therapy, and a modified levofloxacin-containing sequential therapy, in comparison with the standard sequential therapy.…”