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Volume 21, Number 6—June 2015
Research

Risk Factors for Acquisition of Drug Resistance during Multidrug-Resistant Tuberculosis Treatment, Arkhangelsk Oblast, Russia, 2005–2010

Sarah E. SmithComments to Author , Julia Ershova, Natalia Vlasova, Elena Nikishova, Irina Tarasova, Platon Eliseev, Andrey Maryandyshev, Igor G. Shemyakin, Ekaterina V. Kurbatova, and J. Peter Cegielski
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.E. Smith, J. Ershova, E. Kurbatova, J.P. Cegielski); Arkhangelsk Regional Tuberculosis Dispensary, Arkhangelsk, Russia (N. Vlasova, E. Nikishova, I. Tarasova, P. Eliseev, A.O. Maryandyshev); Northern State Medical University, Arkhangelsk (A.O. Maryandyshev); State Research Center for Applied Microbiology and Biotechnology, Obolensk, Russia (I.G. Shemyakin)

Main Article

Table 6

Effect of acquired resistance and treatment on MDR TB treatment outcomes, 132 patients, Arkhangelsk Oblast, Russia, 2005–2010*

Variable† Total Successful treatment outcome, no. (%)‡ Poor treatment outcome, no. (%)§ Fisher exact p value aOR (95% CI)¶
Overall
 132
 94 (71.2)
 38 (28.8)
Acquired resistance to any second-line drug#
Yes 13 6 (46.2) 7 (53.8) 0.05 1.93 (0.54–6.88)
No
 118
 88 (74.6)
 30 (25.4)
Acquired resistance to CAP#
Yes 3 0 3 (100) 0.02 NR
No
 116
 86 (74.1)
 30 (25.9)
Acquired resistance to OFX#
Yes 6 1 (16.7) 5 (83.3) 0.004 10.18 (1.09–95.08)
No
 119
 92 (77.3)
 27 (22.7)
Acquired XDR#
Yes 4 0 (0) 4 (100) 0.004 NR
No
 123
 93 (75.6)
 30 (24.4)
Ever received effective FQ**
Yes 125 93 (74.4) 32 (25.6) 0.002 0.06 (0.01–0.53)††
No
 7
 1 (14.3)
 6 (85.7)
Ever received CAP during current episode
Yes 104 67 (64.4) 37 (35.6) 0.08 1.42 (0.49–4.05)
No
 33
 27 (81.8)
 6 (18.2)
Ever received MOX during current episode
Yes 27 14 (51.9) 13 (48.1) 0.06 1.48 (0.56–3.90)
No
 110
 80 (72.7)
 30 (27.3)
Ever received third-line drug during current episode
Yes 69 40 (58) 29 (42) 0.01 2.68 (1.25–5.75)
No 68 54 (79.4) 14 (20.6)

*aOR, adjusted odds ratio; CAP, capreomycin; FQ, fluoroquinolone; MDR TB, multidrug-resistant tuberculosis; MOX, moxifloxacin; NR, no result; OFX, ofloxacin; XDR, extensively drug-resistant tuberculosis.
†Certain variables were tested for association but omitted from table because results were not statistically significant at α = 0.1.
‡Cure or treatment completion.
§Death or treatment failure.
¶aOR for poor treatment outcome versus successful treatment outcome controlling for extent of drug resistance at baseline, severity of disease, and previous treatment for MDR TB.
#Patient(s) with baseline TB resistance to the respective drug (or drug groups) were not included in the analysis.
**Patient(s) who did not receive treatment with the respective drug during the current episode of MDR TB were not included in the analysis
††16.67 (95% CI 1.89–100.0) aOR of successful treatment outcome vs. poor treatment outcome.

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.
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