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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. VictorComments to Author 
Author affiliations: West Vaal Hospital, Orkney, South Africa (A.D. Calver, T. Liversage, M. Masibi); Stellenbosch University, Tygerberg, South Africa (A.A. Falmer, O.J. Strauss, E.M. Streicher, M. Hanekom, P.D. van Helden, R.M. Warren, T.C. Victor); Harvard School of Public Health, Boston, Massachusetts, USA (M. Murray)

Main Article

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.

Main Article

1These authors contributed equally to this article.

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