M L Rekart, P Thit, M Oluya, S Moe, T Hasan, N Parpieva, K Safaev, A Khristusev, T Zinaida, J Singh, S Allamuratova, I Azamat, C G Restrepo, N Sitali, J Achar, J L Alvaraez, A Sinha
{"title":"2009-2020 年乌兹别克斯坦耐异烟肼结核病管理十年回顾。","authors":"M L Rekart, P Thit, M Oluya, S Moe, T Hasan, N Parpieva, K Safaev, A Khristusev, T Zinaida, J Singh, S Allamuratova, I Azamat, C G Restrepo, N Sitali, J Achar, J L Alvaraez, A Sinha","doi":"10.5588/ijtldopen.23.0533","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Isoniazid (INH, H) resistance is the most common drug-resistant TB pattern, with treatment success rates lower than those in drug-susceptible TB. The WHO recommends a 6-month regimen of rifampicin (RIF, R), ethambutol (EMB, E), pyrazinamide (PZA, Z), and levofloxacin (Lfx) (6REZLfx) for INH-resistant, RIF-susceptible TB (H<sup>R</sup>R<sup>S</sup>-TB). Uzbekistan has a high burden of TB (62/100,000 population) and multidrug-resistant TB (12/100,000 population).</p><p><strong>Methods: </strong>We conducted a retrospective, descriptive study of microbiologically confirmed H<sup>R</sup>R<sup>S</sup>-TB using routinely collected programmatic data from 2009 to 2020.</p><p><strong>Results: </strong>We included 854 H<sup>R</sup>R<sup>S</sup>-TB cases. Treatment success was 80.2% overall. For REZLfx, the treatment success rate was 92.0% over a short treatment duration, with no amplifications to RIF or second-line anti-TB drug resistance. We documented 46 regimens with REZLfx plus linezolid (success 87.0%) and 539 regimens using kanamycin or capreomycin (success 76.6%). We identified 37 treatment failures (4.3%), 30 deaths (3.5%), 25 resistance amplifications (2.9%), including eight to RIF (0.9%), and 99 lost to follow-up (LTFU) cases (11.6%). Unsuccessful outcomes were more common with older age, diabetes, chest X-ray cavities, smear positivity, smear-positive persistence, and male sex. LTFU was more common with injection-containing regimens.</p><p><strong>Conclusions: </strong>REZLfx is a safe and effective first-line treatment for INH-resistant, RIF-susceptible TB. Treatment success was lower and LTFU was higher for injection-containing regimens.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"1 7","pages":"285-291"},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257092/pdf/","citationCount":"0","resultStr":"{\"title\":\"A 10-year review of isoniazid-resistant TB management in Uzbekistan 2009-2020.\",\"authors\":\"M L Rekart, P Thit, M Oluya, S Moe, T Hasan, N Parpieva, K Safaev, A Khristusev, T Zinaida, J Singh, S Allamuratova, I Azamat, C G Restrepo, N Sitali, J Achar, J L Alvaraez, A Sinha\",\"doi\":\"10.5588/ijtldopen.23.0533\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Isoniazid (INH, H) resistance is the most common drug-resistant TB pattern, with treatment success rates lower than those in drug-susceptible TB. The WHO recommends a 6-month regimen of rifampicin (RIF, R), ethambutol (EMB, E), pyrazinamide (PZA, Z), and levofloxacin (Lfx) (6REZLfx) for INH-resistant, RIF-susceptible TB (H<sup>R</sup>R<sup>S</sup>-TB). Uzbekistan has a high burden of TB (62/100,000 population) and multidrug-resistant TB (12/100,000 population).</p><p><strong>Methods: </strong>We conducted a retrospective, descriptive study of microbiologically confirmed H<sup>R</sup>R<sup>S</sup>-TB using routinely collected programmatic data from 2009 to 2020.</p><p><strong>Results: </strong>We included 854 H<sup>R</sup>R<sup>S</sup>-TB cases. Treatment success was 80.2% overall. For REZLfx, the treatment success rate was 92.0% over a short treatment duration, with no amplifications to RIF or second-line anti-TB drug resistance. We documented 46 regimens with REZLfx plus linezolid (success 87.0%) and 539 regimens using kanamycin or capreomycin (success 76.6%). We identified 37 treatment failures (4.3%), 30 deaths (3.5%), 25 resistance amplifications (2.9%), including eight to RIF (0.9%), and 99 lost to follow-up (LTFU) cases (11.6%). Unsuccessful outcomes were more common with older age, diabetes, chest X-ray cavities, smear positivity, smear-positive persistence, and male sex. LTFU was more common with injection-containing regimens.</p><p><strong>Conclusions: </strong>REZLfx is a safe and effective first-line treatment for INH-resistant, RIF-susceptible TB. Treatment success was lower and LTFU was higher for injection-containing regimens.</p>\",\"PeriodicalId\":519984,\"journal\":{\"name\":\"IJTLD open\",\"volume\":\"1 7\",\"pages\":\"285-291\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257092/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"IJTLD open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/ijtldopen.23.0533\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"IJTLD open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/ijtldopen.23.0533","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A 10-year review of isoniazid-resistant TB management in Uzbekistan 2009-2020.
Background: Isoniazid (INH, H) resistance is the most common drug-resistant TB pattern, with treatment success rates lower than those in drug-susceptible TB. The WHO recommends a 6-month regimen of rifampicin (RIF, R), ethambutol (EMB, E), pyrazinamide (PZA, Z), and levofloxacin (Lfx) (6REZLfx) for INH-resistant, RIF-susceptible TB (HRRS-TB). Uzbekistan has a high burden of TB (62/100,000 population) and multidrug-resistant TB (12/100,000 population).
Methods: We conducted a retrospective, descriptive study of microbiologically confirmed HRRS-TB using routinely collected programmatic data from 2009 to 2020.
Results: We included 854 HRRS-TB cases. Treatment success was 80.2% overall. For REZLfx, the treatment success rate was 92.0% over a short treatment duration, with no amplifications to RIF or second-line anti-TB drug resistance. We documented 46 regimens with REZLfx plus linezolid (success 87.0%) and 539 regimens using kanamycin or capreomycin (success 76.6%). We identified 37 treatment failures (4.3%), 30 deaths (3.5%), 25 resistance amplifications (2.9%), including eight to RIF (0.9%), and 99 lost to follow-up (LTFU) cases (11.6%). Unsuccessful outcomes were more common with older age, diabetes, chest X-ray cavities, smear positivity, smear-positive persistence, and male sex. LTFU was more common with injection-containing regimens.
Conclusions: REZLfx is a safe and effective first-line treatment for INH-resistant, RIF-susceptible TB. Treatment success was lower and LTFU was higher for injection-containing regimens.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
