Treatment outcomes of multiple and extensive drug resistant tuberculosis and efficiency of surgical resections in patients with high risk of unfavorable outcomes

Abstract

The retrospective cohort study was aimed to evaluate treatment outcomes of 476 patients suffering from multiple and extensive drug resistance, to detect risk factors of unfavorable outcomes and to assess the impact of surgical resections on treatment outcomes. 71.8% of patients were cured, in 22.7% treatment failed, and 5.5% died during treatment. Main predictors of the unfavorable outcome were destructive changes in the lungs (Odds ratio (OR) 10.0; 95% CI 2.4-41.9), more than 2 segments of the lungs affected by tuberculosis (OR 6.8; 95%- CI 3.9-11.9), positive results of sputum smear microscopy (OR 3.1; 95% CI 2.0-4.9), pre-XDR of M. tuberculosis (OR 1.9; 95% CI 1.3-2.9), concurrent HIV infection (OR 3.3; 95% CI 1.3-8.2), addiction to alcohol and/or substances (OR 4.8; 95% CI 3.1-7.5), treatment interruption (OR 7.3; 95% CI 4.6-11.8), prescription of non-standard chemotherapy regimens (OR 2.2; 95% CI 1.4-3.4), low income (OR 3.4; 95% CI 2.1-5.5), incarceration (OR 2.2; 95% CI 1.3-3.6). Regarding statistical significance the use of surgical resections was related to the reduction of the risk of unfavorable outcomes also among the patients with treatment failure predictors.

Keywords

• туберкулез с множественной и широкой лекарственной устойчивостью
• хирургическое лечение туберкулеза
• резекционные хирургические вмешательства