Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China
Abstract Background Extensively 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. Methods We retrospectively analyzed HIV-uninfected TB case confirmed and tre...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-017-2652-x |
| _version_ | 1828859443569229824 |
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| author | Xiao-chun He Ning-ning Tao Yao Liu Xian-xin Zhang Huai-chen Li |
| author_facet | Xiao-chun He Ning-ning Tao Yao Liu Xian-xin Zhang Huai-chen Li |
| author_sort | Xiao-chun He |
| collection | DOAJ |
| description | Abstract Background Extensively 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. Methods We 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. Results Between 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). Conclusions XDR-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. |
| first_indexed | 2024-12-13T02:18:41Z |
| format | Article |
| id | doaj.art-e8d5d06977e4407b9f95faf8e773c43e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T02:18:41Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e8d5d06977e4407b9f95faf8e773c43e2022-12-22T00:02:49ZengBMCBMC Infectious Diseases1471-23342017-08-011711910.1186/s12879-017-2652-xEpidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, ChinaXiao-chun He0Ning-ning Tao1Yao Liu2Xian-xin Zhang3Huai-chen Li4Department of Respiratory Medicine, Baoji Central HospitalDepartment of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityDepartment of Respiratory Medicine, Shandong Provincial Chest HospitalDepartment of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong UniversityAbstract Background Extensively 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. Methods We 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. Results Between 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). Conclusions XDR-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.http://link.springer.com/article/10.1186/s12879-017-2652-xXDR-TBEpidemiology trendsTreatment outcomesSurvival |
| spellingShingle | Xiao-chun He Ning-ning Tao Yao Liu Xian-xin Zhang Huai-chen Li Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China BMC Infectious Diseases XDR-TB Epidemiology trends Treatment outcomes Survival |
| title | Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China |
| title_full | Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China |
| title_fullStr | Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China |
| title_full_unstemmed | Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China |
| title_short | Epidemiological trends and outcomes of extensively drug-resistant tuberculosis in Shandong, China |
| title_sort | epidemiological trends and outcomes of extensively drug resistant tuberculosis in shandong china |
| topic | XDR-TB Epidemiology trends Treatment outcomes Survival |
| url | http://link.springer.com/article/10.1186/s12879-017-2652-x |
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