Antituberculosis drug resistance among retreatment tuberculosis patients in a referral center in Taipei

Chen Yuan Chiang, Chih J. Hsu, Ruay Ming Huang, Tao Ping Lin, Kwen T. Luh

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background ad Purpose: To determine the prevalence of antituberculosis drug resistance among retreatment tuberculosis patients in a referral center in Taipei. Methods: We reviewed the register of susceptibility testing of the mycobacteriology laboratory of the Chronic Disease Control Bureau to identify patients with positive culture for Mycobacterium tuberculosis in the year 2000-2001. Medical charts were reviewed to determine patients' tuberculosis treatment histories. Patients who had multidrug-resistant (MDR) tuberculosis, defined as documentation of isolates resistant to at least isoniazid and rifampin, were identified. Retreatment tuberculosis patients without prior evidence of MDR tuberculosis were classified into 3 categories, i.e., relapse, treatment after default and treatment after failure, and the frequency and patterns of antituberculosis drug resistance were determined. Results: A total of 317 patients who had received antituberculosis treatment for more than 1 month were identified. Among them, 183 were retreatment cases without prior evidence of MDR tuberculosis, including 93 with relapse, 57 with treatment after default, and 33 with treatment after failure. Among the 183 patients, the prevalence of resistance to any drug was 42.6%; 14.2% were resistant to 1 drug, 13.7% to 2 drugs, 7.1% to 3 drugs, 7.7% to 4 drugs or more, and 24.6% had MDR tuberculosis. The prevalence of any drug resistance among patients with relapse, treatment after default and treatment after failure was 33.3%, 42.1 %, and 69.7%, respectively, while the prevalence of MDR tuberculosis in these groups was 12.9%, 19.3% and 66.7%, respectively. Conclusions: If susceptibility results are unavailable, the World Health Organization-recommended retreatment regimen may be used in retreatment tuberculosis patients. However, the high proportion of MDR tuberculosis among patients with treatment after failure poses a challenge to the efficacy of the retreatment regimen.

Original languageEnglish
Pages (from-to)411-415
Number of pages5
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume103
Issue number6
Publication statusPublished - Jun 2004
Externally publishedYes

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Retreatment
Drug Resistance
Tuberculosis
Referral and Consultation
Multidrug-Resistant Tuberculosis
Treatment Failure
Pharmaceutical Preparations
Recurrence
Therapeutics
Isoniazid
Rifampin
Mycobacterium tuberculosis
Documentation
Chronic Disease

Keywords

  • Drug resistance
  • Retreatment
  • Taiwan
  • Tuberculosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Antituberculosis drug resistance among retreatment tuberculosis patients in a referral center in Taipei. / Chiang, Chen Yuan; Hsu, Chih J.; Huang, Ruay Ming; Lin, Tao Ping; Luh, Kwen T.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 103, No. 6, 06.2004, p. 411-415.

Research output: Contribution to journalArticle

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abstract = "Background ad Purpose: To determine the prevalence of antituberculosis drug resistance among retreatment tuberculosis patients in a referral center in Taipei. Methods: We reviewed the register of susceptibility testing of the mycobacteriology laboratory of the Chronic Disease Control Bureau to identify patients with positive culture for Mycobacterium tuberculosis in the year 2000-2001. Medical charts were reviewed to determine patients' tuberculosis treatment histories. Patients who had multidrug-resistant (MDR) tuberculosis, defined as documentation of isolates resistant to at least isoniazid and rifampin, were identified. Retreatment tuberculosis patients without prior evidence of MDR tuberculosis were classified into 3 categories, i.e., relapse, treatment after default and treatment after failure, and the frequency and patterns of antituberculosis drug resistance were determined. Results: A total of 317 patients who had received antituberculosis treatment for more than 1 month were identified. Among them, 183 were retreatment cases without prior evidence of MDR tuberculosis, including 93 with relapse, 57 with treatment after default, and 33 with treatment after failure. Among the 183 patients, the prevalence of resistance to any drug was 42.6{\%}; 14.2{\%} were resistant to 1 drug, 13.7{\%} to 2 drugs, 7.1{\%} to 3 drugs, 7.7{\%} to 4 drugs or more, and 24.6{\%} had MDR tuberculosis. The prevalence of any drug resistance among patients with relapse, treatment after default and treatment after failure was 33.3{\%}, 42.1 {\%}, and 69.7{\%}, respectively, while the prevalence of MDR tuberculosis in these groups was 12.9{\%}, 19.3{\%} and 66.7{\%}, respectively. Conclusions: If susceptibility results are unavailable, the World Health Organization-recommended retreatment regimen may be used in retreatment tuberculosis patients. However, the high proportion of MDR tuberculosis among patients with treatment after failure poses a challenge to the efficacy of the retreatment regimen.",
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