Imperial College London
Alternate

Professor Francis Drobniewski

Faculty of Medicine, Department of Infectious Disease

Chair in Global Health and Tuberculosis
 
 
 
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Contact

 

f.drobniewski

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Balabanova:2016:10.1136/thoraxjnl-2015-207638,
author = {Balabanova, Y and Ignatyeva, O and Fiebig, L and Riekstina, V and Danilovits, M and Jaama, K and Davidaviciene, E and Radiulyte, B and Popa, CM and Nikolayevskyy, V and Drobniewski, F},
doi = {10.1136/thoraxjnl-2015-207638},
journal = {Thorax},
pages = {854--861},
title = {Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference?},
url = {http://dx.doi.org/10.1136/thoraxjnl-2015-207638},
volume = {71},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background The quality of care for patients with TB in Eastern Europe has improved significantly; nevertheless drug resistance rates remain high. We analysed survival in a cohort of patients with multidrug-resistant and extensively drug-resistant (MDR-/XDR-) TB from Latvia, Lithuania, Estonia and Bucharest city.Methods Consecutive adult new and retreatment patients with culture-confirmed pulmonary MDR-TB registered for treatment in 2009 (and in 2007 in Latvia) were enrolled; prospective survival information was collected.Results A total of 737 patients were included into the cohort. Of all MDR-TB cases, 46% were newly diagnosed; 56% of all MDR-TB cases had no additional resistance to fluoroquinolones or injectable agents, 33% had pre-XDR-TB and 11% XDR-TB. Median survival was 5.9years in patients with MDR-TB and XDR-TB; 1.9years in patients coinfected with HIV. Older age, male gender, alcohol abuse, retirement, co-morbidities, extrapulmonary involvement and HIV coinfection independently worsened survival. Inclusion of fluoroquinolones and injectable agents improves survival in patients with MDR-TB. Pre-XDR and XDR status did not significantly shorten survival as long as fluoroquinolones and injectable agents were part of the regimen. Moxifloxacin seems to improve survival in ofloxacin-susceptible patients when compared with older generation fluoroquinolones.Conclusions The burden of additional resistances in patients with MDR-TB is high likely due to primary transmission of resistant strains. Social and programmatic factors including management of alcohol dependency, expansion of HIV testing and antiretroviral treatment need to be addressed in order to achieve cure and to interrupt transmission. The role of last generation fluoroquinolones and injectable agents in treatment of patients with pre-XDR and XDR-TB needs to be further investigated.
AU  - Balabanova,Y
AU  - Ignatyeva,O
AU  - Fiebig,L
AU  - Riekstina,V
AU  - Danilovits,M
AU  - Jaama,K
AU  - Davidaviciene,E
AU  - Radiulyte,B
AU  - Popa,CM
AU  - Nikolayevskyy,V
AU  - Drobniewski,F
DO  - 10.1136/thoraxjnl-2015-207638
EP  - 861
PY  - 2016///
SN  - 1468-3296
SP  - 854
TI  - Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference?
T2  - Thorax
UR  - http://dx.doi.org/10.1136/thoraxjnl-2015-207638
UR  - http://hdl.handle.net/10044/1/31869
VL  - 71
ER  -
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