Multidrug-resistant tuberculosis in the Northern Territory: A 10-year retrospective case series.

Daniel Judge, Vicki Krause
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Abstract

Background and objective: To describe the clinical characteristics, risk factors, diagnostic modalities, treatments, subsequent outcomes and complications of Multidrug-resistant tuberculosis (MDR-TB) cases residing in the Northern Territory.

Methods: A retrospective case series was conducted of all patients treated for MDR-TB in the Northern Territory between 1 January 2004 and 31 December 2013. This is the first study to analyse data relating to the subset of MDR-TB cases treated in the Northern Territory. Cases were identified by the Northern Territory Centre for Disease Control (NT CDC): the public health unit responsible for the management of tuberculosis in the Northern Territory. Outcome measures included patient demographics, diagnostics, HIV status, treatment methods, outcomes, and complications.

Results and conclusions: Six MDR-TB cases were treated in the Northern Territory; 5 of these were notified by the NT CDC during the study period (1.5% of all Northern Territory TB notifications). The median age of all 6 patients was 31 years (range 21 to 50 years), sex distribution was equal and all were born overseas. Country of birth in a World Health Organization (WHO) high burden MDR-TB country and previous treatment were most highly correlated with a current diagnosis of MDR-TB. Access to rapid drug susceptibility testing reduced the time to effective therapy from 45 to 27 days. Five patients met criteria for the WHO outcome term 'treatment success'. The median length of treatment for the 5 patients treated in Australia was 623 days (537 to 730 days). Side effects to therapy were common and serious. The incidence of MDR-TB in the Northern Territory is similar to other Australian states. Rapid drug susceptibility testing reduces the time to effective therapy. Treatment regimens are complex, toxic and have serious resource implications for health care providers. Successful treatment outcomes are possible with coordinated TB control programs. Commun Dis Intell 2016;40(3):E334-E339.

北领地耐多药结核病:10年回顾性病例系列。
背景和目的:描述北领地耐多药结核病(MDR-TB)病例的临床特征、危险因素、诊断方式、治疗、后续结局和并发症。方法:对2004年1月1日至2013年12月31日在北领地接受耐多药结核病治疗的所有患者进行回顾性病例系列研究。这是第一个分析与北领地治疗的耐多药结核病例亚群有关的数据的研究。北领地疾病控制中心(北领地疾病控制中心)是负责管理北领地结核病的公共卫生单位。结果测量包括患者人口统计学、诊断、HIV状态、治疗方法、结果和并发症。结果与结论:北领地共治疗耐多药结核病6例;在研究期间,北领地疾病预防控制中心通报了其中5例(占所有北领地结核病通报的1.5%)。6例患者年龄中位数为31岁(21 ~ 50岁),性别分布均匀,均为海外出生。出生在世界卫生组织(WHO)的耐多药结核病高负担国家和以前的治疗与当前的耐多药结核病诊断高度相关。获得快速药敏试验将获得有效治疗的时间从45天减少到27天。5名患者符合世卫组织结果术语“治疗成功”的标准。在澳大利亚接受治疗的5例患者的中位治疗时间为623天(537至730天)。治疗的副作用普遍且严重。北领地耐多药结核病的发病率与澳大利亚其他州相似。快速药敏试验减少了有效治疗的时间。治疗方案复杂、有毒,对卫生保健提供者有严重的资源影响。有了协调一致的结核病控制规划,就有可能取得成功的治疗结果。通信芯片,2016;40(3):E334-E339。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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