Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis
Abstract Background About 8% of TB cases worldwide are estimated to have rifampicin-susceptible, isoniazid-resistant tuberculosis (Hr-TB), ranging from 5 to 11% regions. However, Hr-TB has not received much attention while comparing to be given high priority to the management of rifampicin-resistant...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08909-2 |
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| author | Lijie Zhang Xiqin Han Qiping Ge Wei Shu Yuxian Sun Jingtao Gao Shiheng Xie Jingping Wang Weiwei Gao |
| author_facet | Lijie Zhang Xiqin Han Qiping Ge Wei Shu Yuxian Sun Jingtao Gao Shiheng Xie Jingping Wang Weiwei Gao |
| author_sort | Lijie Zhang |
| collection | DOAJ |
| description | Abstract Background About 8% of TB cases worldwide are estimated to have rifampicin-susceptible, isoniazid-resistant tuberculosis (Hr-TB), ranging from 5 to 11% regions. However, Hr-TB has not received much attention while comparing to be given high priority to the management of rifampicin-resistant tuberculosis (RR-TB). This study aimed to compare the differences of treatment effects for Hr-TB and RR-TB, so as to intensify the treatment and management of Hr-TB. Methods A retrospective study was used to collect bacteriologically positive retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis, who were conducted at 29 tuberculosis control institutions in China from July 2009 to June 2021. We assessed effectiveness and safety of retreated patients with isoniazid/ rifampicin resistant pulmonary tuberculosis. Results A total of 147 with either positive smear or cultures were enrolled, and 80 cases were in Hr-TB group and 67 cases were in RR-TB group. There was no significant difference in terms of age, sex, body mass, type of retreatment and comorbid diabetes between the two groups (P > 0.05). The rate of number of lesions involving lung fields ≥ 3 in Hr-TB group 75.9% (60/79) was significantly higher than RR-TB group 56.7% (38/67) (χ2 = 6.077, P = 0.014). There was no statistically significant difference (P = 0.166) with regard to the treatment outcomes of the two groups, the cure rates were 54.7% (41/75) and 53.6% (30/56), respectively, and the failure rate in Hr-TB group 22.7% (17/75) was 10% higher than RR-TB group 10.7% (6/56). The rate of negative sputum smear at the end of the second month (65.7%) in the Hr-TB group was significantly lower than that in the RR-TB group (85.7%) (P = 0.025). There were no significant differences in the incidences of serious adverse reactions and chest X-ray changes between the two groups (P > 0.05). During the 5-year follow-up, recurrence in the Hr-TB group (7 cases, 14.9%) was no significantly lower than that in the RR-TB group (4 cases, 11.8%) (P = 0.754). Conclusion The treatment of retreated Hr-TB patients was difficult and could be statistically similar or considerably worse than RR-TB. It’s urgent to conduct further evaluation of the treatment status quo to guide the guideline development and clinical practice of Hr-TB patients. |
| first_indexed | 2024-03-08T16:23:21Z |
| format | Article |
| id | doaj.art-67ae5350f778413988ceb3f4d39cd0bb |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-08T16:23:21Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-67ae5350f778413988ceb3f4d39cd0bb2024-01-07T12:13:15ZengBMCBMC Infectious Diseases1471-23342024-01-012411810.1186/s12879-023-08909-2Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosisLijie Zhang0Xiqin Han1Qiping Ge2Wei Shu3Yuxian Sun4Jingtao Gao5Shiheng Xie6Jingping Wang7Weiwei Gao8Clinical Center on Tuberculosis, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteClinical Center on Tuberculosis, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis and Thoracic Tumor Research InstituteClinical Center on Tuberculosis, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis and Thoracic Tumor Research InstituteClinical Center on Tuberculosis, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteClinical Center on Tuberculosis, Beijing Chest Hospital, Capital Medical University/ Beijing Tuberculosis and Thoracic Tumor Research InstituteDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteAbstract Background About 8% of TB cases worldwide are estimated to have rifampicin-susceptible, isoniazid-resistant tuberculosis (Hr-TB), ranging from 5 to 11% regions. However, Hr-TB has not received much attention while comparing to be given high priority to the management of rifampicin-resistant tuberculosis (RR-TB). This study aimed to compare the differences of treatment effects for Hr-TB and RR-TB, so as to intensify the treatment and management of Hr-TB. Methods A retrospective study was used to collect bacteriologically positive retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis, who were conducted at 29 tuberculosis control institutions in China from July 2009 to June 2021. We assessed effectiveness and safety of retreated patients with isoniazid/ rifampicin resistant pulmonary tuberculosis. Results A total of 147 with either positive smear or cultures were enrolled, and 80 cases were in Hr-TB group and 67 cases were in RR-TB group. There was no significant difference in terms of age, sex, body mass, type of retreatment and comorbid diabetes between the two groups (P > 0.05). The rate of number of lesions involving lung fields ≥ 3 in Hr-TB group 75.9% (60/79) was significantly higher than RR-TB group 56.7% (38/67) (χ2 = 6.077, P = 0.014). There was no statistically significant difference (P = 0.166) with regard to the treatment outcomes of the two groups, the cure rates were 54.7% (41/75) and 53.6% (30/56), respectively, and the failure rate in Hr-TB group 22.7% (17/75) was 10% higher than RR-TB group 10.7% (6/56). The rate of negative sputum smear at the end of the second month (65.7%) in the Hr-TB group was significantly lower than that in the RR-TB group (85.7%) (P = 0.025). There were no significant differences in the incidences of serious adverse reactions and chest X-ray changes between the two groups (P > 0.05). During the 5-year follow-up, recurrence in the Hr-TB group (7 cases, 14.9%) was no significantly lower than that in the RR-TB group (4 cases, 11.8%) (P = 0.754). Conclusion The treatment of retreated Hr-TB patients was difficult and could be statistically similar or considerably worse than RR-TB. It’s urgent to conduct further evaluation of the treatment status quo to guide the guideline development and clinical practice of Hr-TB patients.https://doi.org/10.1186/s12879-023-08909-2Pulmonary tuberculosisRetreated tuberculosisIsoniazid resistanceRifampicin resistanceTreatment outcome |
| spellingShingle | Lijie Zhang Xiqin Han Qiping Ge Wei Shu Yuxian Sun Jingtao Gao Shiheng Xie Jingping Wang Weiwei Gao Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis BMC Infectious Diseases Pulmonary tuberculosis Retreated tuberculosis Isoniazid resistance Rifampicin resistance Treatment outcome |
| title | Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis |
| title_full | Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis |
| title_fullStr | Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis |
| title_full_unstemmed | Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis |
| title_short | Treatment outcomes of retreated patients with isoniazid/rifampicin resistant pulmonary tuberculosis |
| title_sort | treatment outcomes of retreated patients with isoniazid rifampicin resistant pulmonary tuberculosis |
| topic | Pulmonary tuberculosis Retreated tuberculosis Isoniazid resistance Rifampicin resistance Treatment outcome |
| url | https://doi.org/10.1186/s12879-023-08909-2 |
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