Publication: Prevalence and risk factors of drug-resistant extrapulmonary tuberculosis
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Issued Date
2018-06-01
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ISSN
1752699X
17526981
17526981
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2-s2.0-85043233277
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Respiratory Journal. Vol.12, No.6 (2018), 2101-2109
Suggested Citation
Viboon Boonsarngsuk, Khattiya Mangkang, Pitak Santanirand Prevalence and risk factors of drug-resistant extrapulmonary tuberculosis. Clinical Respiratory Journal. Vol.12, No.6 (2018), 2101-2109. doi:10.1111/crj.12779 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/46612
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Title
Prevalence and risk factors of drug-resistant extrapulmonary tuberculosis
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Abstract
© 2018 John Wiley & Sons Ltd Background: Physicians are usually aware of the occurrence of drug-resistant (DR) pulmonary tuberculosis (PTB), but lack concern about DR-extrapulmonary TB (EPTB). Data regarding the prevalence and risk factors of DR-EPTB remain limited. Objectives: To determine the prevalence and risk factors of DR-EPTB. Methods: A retrospective study was performed in patients who had culture-proven Mycobacterium tuberculosis (MTB) from various specimens between January 2013 and December 2015. Patients were classified into three groups: PTB, EPTB and concomitant PTB and EPTB (PTB + EPTB). Clinical data, chest radiographic extent of disease and patterns of DR were collected. Results: There were 1014 culture-proven MTB specimens (716 pulmonary specimens and 298 extrapulmonary specimens) from 986 patients (648 PTB, 218 EPTB and 120 PTB + EPTB). The prevalences of isoniazid-, rifampicin- and multidrug-resistant EPTB were 7.8%,.5% and.5%, respectively, which were lower than those of PTB. When PTB and EPTB coexisted, a higher rate of DR-TB was observed than for PTB alone. Of 338 EPTB patients, the extent of radiographic disease was associated with isoniazid-, rifampicin- and multidrug-resistant TB. Previous history of TB and use of steroids/immunosuppressive drugs were also associated with rifampicin- and multidrug-resistant TB in multivariate analysis. Conclusions: The prevalence of DR-EPTB was high in patients who had concomitant PTB. Although the prevalences of rifampicin- and multidrug-resistant TB were low in isolated EPTB, the prevalence of isoniazid-resistant TB remained high. Therefore, drug susceptibility testing should be performed in EPTB patients, especially those who carry the aforementioned risk factors.