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Free Content Clinical outcomes of pyrazinamide-monoresistant Mycobacterium tuberculosis in Quebec

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BACKGROUND: In Quebec, 6.2% of all tuberculosis (TB) isolates from Canadian-born patients are resistant to pyrazinamide (PZA) alone. The clinical significance of PZA-monoresistant (PZAMR) TB is unknown.

METHODS: Canadian-born patients with PZAMR TB diagnosed between 1 January 1990 and 31 December 2000 and reported in a prior study were compared to randomly selected Canadian-born patients with fully susceptible isolates diagnosed within the same time period.

RESULTS: A total of 318 patients were eligible, of whom 40 (12.6%) had missing outcome information. Mean total duration of treatment was respectively 9.0 and 8.9 months for those with PZAMR and pan-susceptible strains. Respectively 91% and 89% of PZAMR and pan-susceptible patients received at least 6 months of rifampin-containing treatment. Among 67 patients with PZAMR TB, 51 (76%) were cured, 3 (4%) relapsed, none failed treatment, and 16 (24%) died within 6 months of diagnosis. Of 211 subjects with fully susceptible isolates, 181 (86%) were cured, 2 (1%) relapsed, 2 (1%) failed treatment, and 30 (14%) died within 6 months of diagnosis. PZA monoresistance was associated with decreased odds of successful clinical outcomes compared with pan-susceptible TB (OR 0.4, 95%CI 0.2–0.8).

CONCLUSION: Patients with PZAMR TB had significantly worse clinical outcomes than patients with fully susceptible strains.
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Keywords: clinical outcome; cure rates; drug resistance; mortality rates; pyrazinamide; tuberculosis

Document Type: Research Article

Affiliations: 1: Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Center, Montreal, Quebec, Canada 2: Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada; Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada

Publication date: 2012-05-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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