Clinical characteristics and treatment outcomes of patients with low- and high-concentration isoniazid-monoresistant tuberculosis

Tsai Yu Wang, Shu Min Lin, Shian Sen Shie, Pai Chien Chou, Chien Da Huang, Fu Tsai Chung, Chih His Kuo, Po Jui Chang, Han Pin Kuo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Isoniazid (INH) resistance is now the most common type of tuberculosis (TB) infection resistance worldwide. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of patients with low- and high-concentration INH-monoresistant TB. Methods: One hundred and thirty-four patients with culture-confirmed INH-monoresistant TB during 2006 January to 2007 December were retrospectively enrolled. INH resistance was classified as either low-concentration or high-concentration resistance according to the critical concentrations of 0.2 μg/mL or 1 μg/mL of INH, respectively. The patients' clinical outcomes, treatment regimens, and treatment duration were analyzed. Results: The treatment success rates between low- and high-concentration INH-resistant TB were similar (81.8% vs. 86.7%). The treatment regimens and treatment duration were similar between both groups. Only a minor percentage of the patients in both groups received 6-month treatment regimens (low vs. high concentration resistance, 9.1% vs. 13.3%; respectively, p = 0.447) The most common reason for treatment duration longer than 6 months was pyrazinamide given for less than 6 months, followed by a delay in clinical response to treatment. Multivariable analysis showed that prior tuberculosis treatment (Odds ratio, 2.82, 95% C.I., 1.02-7.77, p = 0.045) was the only independent risk factor for unsuccessful treatment outcome. Conclusion: Different levels of INH resistance did not affect the treatment outcomes of patients with INH-monoresistant tuberculosis. Prolonged Rifampin-containing regimens may achieve those good outcomes in patients with low- and high-concentration INH-monoresistant TB.

Original languageEnglish
Article numbere86316
JournalPLoS One
Volume9
Issue number1
DOIs
Publication statusPublished - Jan 22 2014

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isoniazid
Pyrazinamide
Isoniazid
Rifampin
tuberculosis
Tuberculosis
Therapeutics
duration
rifampicin
odds ratio
risk factors
Odds Ratio
infection

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Clinical characteristics and treatment outcomes of patients with low- and high-concentration isoniazid-monoresistant tuberculosis. / Wang, Tsai Yu; Lin, Shu Min; Shie, Shian Sen; Chou, Pai Chien; Huang, Chien Da; Chung, Fu Tsai; Kuo, Chih His; Chang, Po Jui; Kuo, Han Pin.

In: PLoS One, Vol. 9, No. 1, e86316, 22.01.2014.

Research output: Contribution to journalArticle

Wang, Tsai Yu ; Lin, Shu Min ; Shie, Shian Sen ; Chou, Pai Chien ; Huang, Chien Da ; Chung, Fu Tsai ; Kuo, Chih His ; Chang, Po Jui ; Kuo, Han Pin. / Clinical characteristics and treatment outcomes of patients with low- and high-concentration isoniazid-monoresistant tuberculosis. In: PLoS One. 2014 ; Vol. 9, No. 1.
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abstract = "Background: Isoniazid (INH) resistance is now the most common type of tuberculosis (TB) infection resistance worldwide. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of patients with low- and high-concentration INH-monoresistant TB. Methods: One hundred and thirty-four patients with culture-confirmed INH-monoresistant TB during 2006 January to 2007 December were retrospectively enrolled. INH resistance was classified as either low-concentration or high-concentration resistance according to the critical concentrations of 0.2 μg/mL or 1 μg/mL of INH, respectively. The patients' clinical outcomes, treatment regimens, and treatment duration were analyzed. Results: The treatment success rates between low- and high-concentration INH-resistant TB were similar (81.8{\%} vs. 86.7{\%}). The treatment regimens and treatment duration were similar between both groups. Only a minor percentage of the patients in both groups received 6-month treatment regimens (low vs. high concentration resistance, 9.1{\%} vs. 13.3{\%}; respectively, p = 0.447) The most common reason for treatment duration longer than 6 months was pyrazinamide given for less than 6 months, followed by a delay in clinical response to treatment. Multivariable analysis showed that prior tuberculosis treatment (Odds ratio, 2.82, 95{\%} C.I., 1.02-7.77, p = 0.045) was the only independent risk factor for unsuccessful treatment outcome. Conclusion: Different levels of INH resistance did not affect the treatment outcomes of patients with INH-monoresistant tuberculosis. Prolonged Rifampin-containing regimens may achieve those good outcomes in patients with low- and high-concentration INH-monoresistant TB.",
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AU - Lin, Shu Min

AU - Shie, Shian Sen

AU - Chou, Pai Chien

AU - Huang, Chien Da

AU - Chung, Fu Tsai

AU - Kuo, Chih His

AU - Chang, Po Jui

AU - Kuo, Han Pin

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N2 - Background: Isoniazid (INH) resistance is now the most common type of tuberculosis (TB) infection resistance worldwide. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of patients with low- and high-concentration INH-monoresistant TB. Methods: One hundred and thirty-four patients with culture-confirmed INH-monoresistant TB during 2006 January to 2007 December were retrospectively enrolled. INH resistance was classified as either low-concentration or high-concentration resistance according to the critical concentrations of 0.2 μg/mL or 1 μg/mL of INH, respectively. The patients' clinical outcomes, treatment regimens, and treatment duration were analyzed. Results: The treatment success rates between low- and high-concentration INH-resistant TB were similar (81.8% vs. 86.7%). The treatment regimens and treatment duration were similar between both groups. Only a minor percentage of the patients in both groups received 6-month treatment regimens (low vs. high concentration resistance, 9.1% vs. 13.3%; respectively, p = 0.447) The most common reason for treatment duration longer than 6 months was pyrazinamide given for less than 6 months, followed by a delay in clinical response to treatment. Multivariable analysis showed that prior tuberculosis treatment (Odds ratio, 2.82, 95% C.I., 1.02-7.77, p = 0.045) was the only independent risk factor for unsuccessful treatment outcome. Conclusion: Different levels of INH resistance did not affect the treatment outcomes of patients with INH-monoresistant tuberculosis. Prolonged Rifampin-containing regimens may achieve those good outcomes in patients with low- and high-concentration INH-monoresistant TB.

AB - Background: Isoniazid (INH) resistance is now the most common type of tuberculosis (TB) infection resistance worldwide. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of patients with low- and high-concentration INH-monoresistant TB. Methods: One hundred and thirty-four patients with culture-confirmed INH-monoresistant TB during 2006 January to 2007 December were retrospectively enrolled. INH resistance was classified as either low-concentration or high-concentration resistance according to the critical concentrations of 0.2 μg/mL or 1 μg/mL of INH, respectively. The patients' clinical outcomes, treatment regimens, and treatment duration were analyzed. Results: The treatment success rates between low- and high-concentration INH-resistant TB were similar (81.8% vs. 86.7%). The treatment regimens and treatment duration were similar between both groups. Only a minor percentage of the patients in both groups received 6-month treatment regimens (low vs. high concentration resistance, 9.1% vs. 13.3%; respectively, p = 0.447) The most common reason for treatment duration longer than 6 months was pyrazinamide given for less than 6 months, followed by a delay in clinical response to treatment. Multivariable analysis showed that prior tuberculosis treatment (Odds ratio, 2.82, 95% C.I., 1.02-7.77, p = 0.045) was the only independent risk factor for unsuccessful treatment outcome. Conclusion: Different levels of INH resistance did not affect the treatment outcomes of patients with INH-monoresistant tuberculosis. Prolonged Rifampin-containing regimens may achieve those good outcomes in patients with low- and high-concentration INH-monoresistant TB.

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