Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 21, Number 6—June 2015
CME ACTIVITY - Research

Acquired Drug Resistance in Mycobacterium tuberculosis and Poor Outcomes among Patients with Multidrug-Resistant Tuberculosis

Russell R. KempkerComments to Author , Maia Kipiani, Veriko Mirtskhulava, Nestani Tukvadze, Matthew J. Magee, and Henry M. Blumberg
Author affiliations: Emory University School of Medicine, Atlanta, Georgia, USA (R.R. Kempker, H.M. Blumberg); National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia (M. Kipiani, N. Tukvadze); Davit Tvildiani Medical University, Tbilisi (V. Mirtskhulava); Georgia State University School of Public Health, Atlanta (M.J. Magee)

Main Article

Table 2

Risk factors for acquired resistance to second-line drugs among patients treated for multidrug-resistant tuberculosis, Georgia, March 2009–October 2012*

Risk factor Univariate analysis, OR (95% CI) p value Multivariate analysis, aOR (95% CI) p value
Baseline characteristic
Median age >35 y 1.96 (0.72–5.30) 0.19
Male sex 2.15 (0.59–7.83) 0.25
BMI ≤18.5 kg/m2 1.96 (0.70–5.45) 0.20 3.73 (0.98–14.14) 0.053
History of TB 1.50 (0.57–3.94) 0.42
Prior receipt of second-line TB drugs 3.08 (0.72–13.13) 0.13
Diabetes 0.40 (0.05–3.19) 0.38
Hepatitis C 1.57 (0.40–6.13) 0.52
HIV 1.30 (0.14–11.78) 0.82
Cavitary disease 7.45 (2.65–20.96) <0.01 5.21 (1.56–17.38) <0.01
No. of drugs to which baseline isolate was resistant/drug (IQR) 1.63 (1.05–2.51) 0.03
Resistant to ≥6 drugs by baseline DST 4.63 (1.56–13.68) <0.01 5.31 (1.50–18.77) 0.01
Baseline ofloxacin resistant 6.24 (1.51–25.83) 0.01
Baseline capreomycin or kanamycin resistant 1.20 (0.44–3.27) 0.73
Known active drugs in initial regimen per drug 0.58 (0.35–0.99) 0.045
Follow-up characteristic
Initial MDR TB treatment
Capreomycin 2.92 (1.04–8.18) 0.04
Treatment interruption 2.93 (1.08–7.99) 0.04
>30 d to start SLDs 0.48 (0.17–1.34) 0.16
Baseline AFB sputum smear value >3+ 4.44 (1.61–12.22) <0.01 2.21 (0.66–7.48) 0.20
Sputum smear positive, mo†
4 8.78 (1.95–39.66) <0.01 6.54 (1.23–34.88) 0.03
6‡ 15.31 (4.66–50.32) <0.01

*OR, odds ratio; aOR, adjusted OR; –, not included in multivariate analysis; BMI, body mass index; TB, tuberculosis; IQR, interquartile range; DST, drug susceptibility testing; MDR, multidrug resistant; SLDs, second-line drugs; AFB, acid-fast bacilli.
†Time from initiation of second-line drug treatment for MDR TB.
‡Significant by an alternative multivariate analysis model when replacing the variable sputum smear positive at 4 mo.

Main Article

Page created: May 15, 2015
Page updated: May 15, 2015
Page reviewed: May 15, 2015
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.
file_external