Volume 16, Number 2—February 2010
Research
Emergence of Increased Resistance and Extensively Drug-Resistant Tuberculosis Despite Treatment Adherence, South Africa
Alistair D. Calver1, Alecia A. Falmer1, Megan Murray, Odelia J. Strauss, Elizabeth M. Streicher, Madelene Hanekom, Thelma Liversage, Mothusi Masibi, Paul D. van Helden, Robin M. Warren, and Thomas C. Victor
Table 1
Characteristics of mine workers with drug-resistant TB diagnosed January 2003–January 2005, South Africa*
| Drug-resistance phenotype | ||||
|---|---|---|---|---|
| Isoniazid (mono) resistant | 8 (9.5) | 1 (14.3) | 4 (10.8) | 13 (10.1) |
| Poly resistant | 4 (4.8) | 0 | 3 (8.1) | 7 (5.5) |
| MDR | 72 (85.7) | 6 (85.7) | 30 (81.1) | 108 (84.4) |
| Pre–XDR | 22 (26.2) | 3 (42.9) | 1 (2.7) | 26 (20.3) |
| XDR |
2 (2.4) |
1 (14.3) |
2 (5.4) |
5 (3.9) |
| Outcome | ||||
| Treatment completed or bacteriologic cure | 26 (30.1) | 3 (42.9) | 11 (29.7) | 40 (31.3) |
| Failed | 1 (1.3) | 0 | 0 | 1 (0.8) |
| Died | 31(36.9) | 2 (28.6) | 12 (32.4) | 45 (35.2) |
| Transferred out | 20 (23.8) | 2 (28.6) | 10 (27.0)) | 32 (25.0) |
| Lost to treatment§ |
6 (7.1) |
0 |
4 (10.8) |
10 (7.8) |
| CD4 cell count, cells/mm3¶ | ||||
| <200 | 52 (62) | ND | 5 (13.5) | 57 (44.5) |
| >200 | 18 (21.4) | 2 (28.6) | ND | 20 (15.6) |
*TB, tuberculosis; MDR, multidrug-resistant; XDR, extensively drug-resistant; ND, not determined.
†All prior TB episodes were treated at the mine.
‡1 sputum smear result missing.
§One had monoresistant TB and 9 had MDR TB.
¶CD4 counts available for 77 patients only.
