Publication: Effect of mycobacterial drug resistance patterns on patients' survival: a cohort study in Thailand.
Issued Date
2013-01-01
Resource Type
ISSN
19169736
Other identifier(s)
2-s2.0-84893113689
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Global journal of health science. Vol.5, No.6 (2013), 60-72
Suggested Citation
Amornrat Anuwatnonthakate, Sara J. Whitehead, Jay K. Varma, Udomsak Silachamroon, Yuthichai Kasetjaroen, Saiyud Moolphate, Pranom Limsomboon, Jiraphun Inyaphong, Narin Suriyon, Suporn Kavinum, Navarat Chiengson, Phatchara Tunteerapat, Jaranit Kaewkungwal Effect of mycobacterial drug resistance patterns on patients' survival: a cohort study in Thailand.. Global journal of health science. Vol.5, No.6 (2013), 60-72. doi:10.5539/gjhs.v5n6p60 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32591
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Effect of mycobacterial drug resistance patterns on patients' survival: a cohort study in Thailand.
Other Contributor(s)
Abstract
Drug resistance substantially increases tuberculosis (TB) mortality. This study aimed to describe the prevalence of mycobacterial drug resistance pattern and association of common resistance patterns with TB mortality in Thailand. A retrospective cohort study was conducted using TB surveillance data. A total of 9,518 culture-confirmed, pulmonary TB patients registered from 1 October 2004 to 31 December 2008 from the Thailand TB Active Surveillance Network were included in this study. Patients were followed up until TB treatment completion or death. Mycobacterial drug resistance patterns were categorized as pan-susceptible, rifampicin resistance, isoniazid monoresistance, and ethambutol/streptomycin resistance. Drug susceptibility testing (DST) was determined by Mycobacterial Growth Indicator Tube (MGIT) liquid culture systems. Survival analysis was applied. Isoniazid monoresistance was the most common pattern, while rifampicin resistance had the largest impact on mortality. Cox regression analysis showed a significantly higher risk of death among patients with rifampicin resistance (adjusted hazard ratio (aHR) 1.9, 95% confident interval (CI), 1.5-2.5) and isoniazid monoresistance (aHR 1.4, 95% CI 1.1-1.7) than those with pan-susceptible group after adjustment for age, nationality, human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status, diabetes mellitus, cavitary disease on chest x-ray, treatment observation, and province. HIV co-infection was associated with higher mortality in patients both on ART (aHR 1.9, 95% CI 1.5-2.5) and not on ART (aHR 8.1, 95% CI 6.8-9.8). Rifampicin resistance and isoniazid monoresistance were associated with increased TB mortality. HIV-coinfection was associated with a higher risk of death including among those taking antiretroviral therapy.