原创力文档risk factors for mdr and xdr-tb in a tertiary referral hospital in india耐多药和广泛耐药结核病的风险因素在印度在三级转诊医院.pdfVIP
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risk factors for mdr and xdr-tb in a tertiary referral hospital in india耐多药和广泛耐药结核病的风险因素在印度在三级转诊医院
Risk Factors for MDR and XDR-TB in a Tertiary Referral
Hospital in India
1 2 3 2 1
V. Balaji , Peter Daley *, Alok Azad Anand , Thambu Sudarsanam , Joy Sarojini Michael , Rani Diana
1 2 2 2 2 4 2
Sahni , Poorvi Chordia , Ige Abraham George , Kurien Thomas , Alka Ganesh , K. R. John , Dilip Mathai
1 Department of Microbiology, Christian Medical College Vellore, Vellore, Tamil Nadu, India, 2 Department of Medicine, Christian Medical College Vellore, Vellore, Tamil
Nadu, India, 3 Tufts University School of Medicine, Boston, Massachusetts, United States of America, 4 Department of Community Medicine, Christian Medical College
Vellore, Vellore, Tamil Nadu, India
Abstract
Background: India has a high burden of drug resistant TB, although there are few data on XDR-TB. Although XDR-TB has
existed previously in India, the definition has not been widely applied, and surveillance using second line drug susceptibility
testing has not been performed. Our objective was to analyze clinical and demographic risk factors associated with isolation
of MDR and XDR TB as compared to susceptible controls, at a tertiary center.
Methodology/Findings: Retrospective chart review based on positive cultures isolated in a high volume mycobacteriology
laboratory between 2002 and 2007. 47 XDR, 30 MDR and 117 susceptible controls were examined. Drug resistant cases were
less likely to be extrapulmonary, and had received more previous treatment regimens. Significant risk factors for XDR-TB
included residence outside the local state (OR 7.43, 3.07-18.0) and care costs subsidized (OR 0.23, 0.097-0.54) in bivariate
analysis and previous use of a
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