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  • Title: Survival and predictors of outcomes in non-HIV-infected patients with extensively drug-resistant tuberculosis.
    Author: Jeon DS, Kim DH, Kang HS, Hwang SH, Min JH, Kim JH, Sung NM, Carroll MW, Park SK.
    Journal: Int J Tuberc Lung Dis; 2009 May; 13(5):594-600. PubMed ID: 19383192.
    Abstract:
    SETTING: A tuberculosis (TB) referral hospital in South Korea. OBJECTIVE: To evaluate predictors of treatment outcomes and survival among non-human immunodeficiency virus (HIV) infected patients with extensively drug-resistant TB (XDR-TB). DESIGN: Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. We conducted a retrospective review of their medical records and mortality data. RESULTS: A total of 176 non-HIV-infected patients with XDR-TB were included. TB-related mortality was 48% (84/176), and the median survival time from the diagnosis date of XDR-TB was 51 months (range 0-127, 95%CI 32.53-69.47). Cure and treatment completion were classified as favourable outcome and treatment failure, death during treatment and default as poor outcome. Previous TB treatment with second-line drugs (aOR 2.76, 95%CI 1.02-7.44) and cavitary disease (aOR 3.01, 95%CI 1.12-8.08) were independent risk factors for poor outcome. Use of linezolid (aOR 0.10, 95%CI 0.01-0.69) and surgical resection (aOR 0.18, 95%CI 0.04-0.78) were associated with favourable outcome. CONCLUSION: There was high mortality in non-HIV-infected patients with XDR-TB at a TB referral hospital in South Korea. Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB.
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