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Risk Factors for Poor Treatment Outcomes in Patients With MDR-TB and XDR-TB in China: Retrospective Multicenter Investigation FREE TO VIEW

Shenjie Tang, PhD; Shouyong Tan, PhD; Lan Yao, PhD; Fujian Li, PhD; Li Li, PhD; Zhixin Guo, PhD; Yidian Liu, MD; Xiaohui Hao, PhD; Yanqiong Li, MD; Xiuxiu Ding, MD; Zhanjun Zhang, MD; Li Tong, MD; Jianan Huang, PhD
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Shanghai Pulmonary Hospital, Shanghai, China

Chest. 2014;145(3_MeetingAbstracts):136A. doi:10.1378/chest.1836288
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SESSION TITLE: Tuberculosis Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Multidrug resistant tuberculosis (MDR-TB) and extensively drug-resistant (XDR-TB) is a major public health threat in China. To investigate risk factors for poor treatment outcomes in patients with MDR-TB and XDR-TB in China.

METHODS: We retrospectively analyzed TB Patients with culture-proven MDR-TB and HIV-negative from July 2006 to June 2010 in five large-scale Tuberculosis Specialized Hospitals in China.

RESULTS: A total of 586 HIV-negative patients with MDR-TB were included in the final analysis. Among them, 169 cases (28.8%) had XDR-TB. The patients were divided into XDR-TB group (n=169) and other MDR-TB group (MDR-TB excluding XDR-TB) (n=417). In total, 240 patients (40.95%) had treatment Success, and 346 (59.05%) had Poor treatment outcomes. The treatment success rate in other MDR-TB group was 52.2%, significantly higher than that in XDR-TB group (13%, P<0.001), whereas poor treatment outcomes were more common in patients with XDR-TB than in patients with other MDR-TB (87 vs.47.8%; P<0.001). In multivariate logistic regression analysis, Poor Treatment Outcomes were associated with duration of previous anti-TB treatment of more than one year, a BMI less than 18.5 kg/m2, XDR, retreatment, diabetes, tumor, decreased albumin, cavitation and 5~6 lung fields with disease. In multivariate logistic regression analysis, having a tumor was the only independent risk factor associated with death.

CONCLUSIONS: The prevalence of MDR- and XDR-TB is high in some areas in China with poor treatment outcome. The presence of XDR, low BMI, hypoalbuminemia, comorbidity and previous anti-TB treatment are independent poor prognostic factors in patients with MDR-TB. Effective TB control strategies should be implemented to prevent the development and spread of MDR- and XDR-TB in China.

CLINICAL IMPLICATIONS: This study clarified the risk factors associated with poor treatment outcome among patients with MDR- and XDR-TB, which provides imprtant evidence to treat the patients with MDR- and XDR-TB better.

DISCLOSURE: The following authors have nothing to disclose: Shenjie Tang, Shouyong Tan, Lan Yao, Fujian Li, Li Li, Zhixin Guo, Yidian Liu, Xiaohui Hao, Yanqiong Li, Xiuxiu Ding, Zhanjun Zhang, Li Tong, Jianan Huang

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