Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis.

Hdl Handle:
http://hdl.handle.net/10144/91158
Title:
Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis.
Authors:
Matthys, F; Rigouts, L; Sizaire, V; Vezhnina, N; Lecoq, M; Golubeva, V; Portaels, F; Van der Stuyft, P; Kimerling, M
Journal:
PloS One
Abstract:
Standard short course chemotherapy is recommended by the World Health Organization to control tuberculosis worldwide. However, in settings with high drug resistance, first line standard regimens are linked with high treatment failure. We evaluated treatment outcomes after standardized chemotherapy with the WHO recommended category II retreatment regimen in a prison with a high prevalence of drug resistant tuberculosis (TB). A cohort of 233 culture positive TB patients was followed through smear microscopy, culture, drug susceptibility testing and DNA fingerprinting at baseline, after 3 months and at the end of treatment. Overall 172 patients (74%) became culture negative, while 43 (18%) remained positive at the end of treatment. Among those 43 cases, 58% of failures were determined to be due to treatment with an inadequate drug regimen and 42% to either an initial mixed infection or re-infection while under treatment. Overall, drug resistance amplification during treatment occurred in 3.4% of the patient cohort. This study demonstrates that treatment failure is linked to initial drug resistance, that amplification of drug resistance occurs, and that mixed infection and re-infection during standard treatment contribute to treatment failure in confined settings with high prevalence of drug resistance.
Affiliation:
Epidemiological and Disease Control Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. fmatthys@itg.be
Publisher:
PLoS
Issue Date:
Dec-2009
URI:
http://hdl.handle.net/10144/91158
DOI:
10.1371/journal.pone.0007954
PubMed ID:
19956770
Language:
en
ISSN:
1932-6203
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorMatthys, Fen
dc.contributor.authorRigouts, Len
dc.contributor.authorSizaire, Ven
dc.contributor.authorVezhnina, Nen
dc.contributor.authorLecoq, Men
dc.contributor.authorGolubeva, Ven
dc.contributor.authorPortaels, Fen
dc.contributor.authorVan der Stuyft, Pen
dc.contributor.authorKimerling, Men
dc.date.accessioned2010-02-04T21:21:56Z-
dc.date.available2010-02-04T21:21:56Z-
dc.date.issued2009-12-
dc.identifier.citationOutcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis. 2009, 4 (11):e7954 PLoS ONEen
dc.identifier.issn1932-6203-
dc.identifier.pmid19956770-
dc.identifier.doi10.1371/journal.pone.0007954-
dc.identifier.urihttp://hdl.handle.net/10144/91158-
dc.description.abstractStandard short course chemotherapy is recommended by the World Health Organization to control tuberculosis worldwide. However, in settings with high drug resistance, first line standard regimens are linked with high treatment failure. We evaluated treatment outcomes after standardized chemotherapy with the WHO recommended category II retreatment regimen in a prison with a high prevalence of drug resistant tuberculosis (TB). A cohort of 233 culture positive TB patients was followed through smear microscopy, culture, drug susceptibility testing and DNA fingerprinting at baseline, after 3 months and at the end of treatment. Overall 172 patients (74%) became culture negative, while 43 (18%) remained positive at the end of treatment. Among those 43 cases, 58% of failures were determined to be due to treatment with an inadequate drug regimen and 42% to either an initial mixed infection or re-infection while under treatment. Overall, drug resistance amplification during treatment occurred in 3.4% of the patient cohort. This study demonstrates that treatment failure is linked to initial drug resistance, that amplification of drug resistance occurs, and that mixed infection and re-infection during standard treatment contribute to treatment failure in confined settings with high prevalence of drug resistance.en
dc.language.isoenen
dc.publisherPLoSen
dc.rightsPublished by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permissionen
dc.titleOutcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis.en
dc.contributor.departmentEpidemiological and Disease Control Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. fmatthys@itg.been
dc.identifier.journalPloS Oneen

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