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Volume 17, Number 3—March 2011
Dispatch

Increasing Drug Resistance in Extensively Drug-Resistant Tuberculosis, South Africa

N. Sarita ShahComments to Author , Jessica Richardson, Prashini Moodley, Salona Moodley, Palav Babaria, Melissa Ramtahal, Scott K. Heysell, Xuan Li, Anthony P. Moll, Gerald Friedland, A. Willem Sturm, and Neel R. Gandhi
Author affiliations: Author affiliations: Tugela Ferry Care and Research Collaboration, Tugela Ferry, South Africa (N.S. Shah, J. Richardson, P. Babaria, S.K. Heysell, A.P. Moll, G. Friedland, N.R. Gandhi); Albert Einstein College of Medicine, Bronx, New York, USA (N.S. Shah, J. Richardson, X. Li, N.R. Gandhi); Montefiore Medical Center, Bronx (N.S. Shah, J. Richardson, X. Li, N.R. Gandhi); Nelson R. Mandela School of Medicine, Durban, South Africa (P. Moodley, S. Moodley, M. Ramtahal, A.W. Sturm); Yale University, New Haven, Connecticut, USA (P. Babaria, G. Friedland); Philanjalo Care Center, Tugela Ferry (A.P. Moll)

Main Article

Table 2

Characteristics of 30 MDR TB and XDR TB patients, South Africa*

Characteristic MDR TB 6- or 7-drug XDR TB 8-drug XDR TB
Total 11 6 13
Female sex 8 (73) 4 (67) 5 (38)
Age, y, median (range)
 36 (26–52)
 42.5 (36–64)
 33.5 (24–51)
Prior TB treatment
First-line drugs† 5 (45) 5 (83) 5 (38)
Second-line drugs‡
 0
 0
 0
TB contact 2 (18) 2 (33) 1 (8)
Enrollment site at HIV clinic 8 (73) 2 (33) 7 (54)
HIV positive 10 (91) 5 (83) 12 (92)
CD4 cell count, cells/mm3, median (range) 155 (25–708) 117.5 (18–426) 183.5 (22–670)
Receiving antiretroviral therapy (among HIV-positive patients) 7 (70) 2 (40) 2 (17)

*Values are no. (%) unless otherwise indicated. MDR TB, multidrug-resistant tuberculosis; XDR TB, extensively drug-resistant TB. 6-drug resistance, resistance to isoniazid, rifampin, ethambutol, ofloxacin, kanamycin, and streptomycin; 7-drug resistance, resistance to isoniazid, rifampin, ethambutol, ofloxacin, kanamycin, streptomycin, and capreomycin; 8-drug resistance, resistance to isoniazid, rifampin, ethambutol, ofloxacin, kanamycin, streptomycin, capreomycin, and ethionamide.
†First-line drugs used for treatment of persons with new TB cases or confirmed drug-susceptible TB include isoniazid, rifampin, ethambutol, and pyrazinamide.
‡Second-line drugs used for treatment of persons with confirmed MDR TB include ofloxacin, kanaymycin, ethionamide, p-aminosalicylic acid, and cycloserine or terizidone.

Main Article

Page created: July 25, 2011
Page updated: July 25, 2011
Page reviewed: July 25, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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