Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China

BMC Infectious Diseases

Research Article

Xiao-chun He¹  Xian-xin Zhang²  Huai-chen Li³  Yao Liu³  Ning-ning Tao³ 

[1] Department of Respiratory Medicine, Baoji Central Hospital, Baoji, Shaanxi, China;Department of Respiratory Medicine, Shandong Provincial Chest Hospital, Jinan, Shandong, China;Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China;

关键词: XDR-TB;    Epidemiology trends;    Treatment outcomes;    Survival;   

DOI  :  10.1186/s12879-017-2652-x

 received in 2016-11-30, accepted in 2017-07-30,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundExtensively Drug-Resistant (XDR) Tuberculosis (TB) has posed a great threat to global health and finance systems, especially for developing countries with high TB and Multidrug-Resistant (MDR) TB burden.MethodsWe retrospectively analyzed HIV-uninfected TB case confirmed and treated in Shandong Provincial Chest Hospital (SPCH) between January 2008 and December 2015. Unique characteristics of XDR-TB were identified; its longitudinal changes and survival were analyzed.ResultsBetween January 2008 and December 2015, a total of 144 cases were confirmed to be XDR-TB (2.5% of 5663 culture-confirmed TB cases; 27.9% of 516 MDR-TB cases). The proportion of XDR TB cases among MDR-TB cases has increased from 26.5% in 2008 to 44.5% in 2014 (Chi-Square test for trends: P < 0.01). Among the 144 XDR-TB cases, 21 patients (14.6%) had treatment success, 123 (85.1%) had poor treatment outcomes. Mortality was higher among XDR-TB cases than among MDR TB cases (8.3% vs. 3.8%, P = 0.033) and drug-susceptible TB cases (8.3% vs. 2.1%, P < 0.01).ConclusionsXDR-TB cases comprise a substantial and increasing fraction of MDR-TB cases, causing poor treatment outcomes and high mortalities. Early drug susceptibility testing, adequate TB treatment and efficient infection control must be in place in future TB control strategies.

【 授权许可】

CC BY   
© The Author(s). 2017