Clinical outcomes of pyrazinamide-monoresistant Mycobacterium tuberculosis in Quebec
Source: The International Journal of Tuberculosis and Lung Disease, Volume 16, Number 5, 1 May 2012 , pp. 604-609(6)
Abstract: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.
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: 1 May 2012
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