Treatment Outcomes And Key Factors Contributing to Unfavorable Outcomes Among Isoniazid-Resistant Pulmonary Tuberculosis Patients in Shanghai, China.

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2025-02-27 DOI:10.1016/j.jgar.2025.02.003

Wenjing Xiao, Jing Chen, Lixin Rao, Xiao Xiao, Xubin Zheng, Zheyuan Wu, Xin Shen

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Abstract

Objectives: Given that more than 1 million people annually develop isoniazid-resistant tuberculosis (Hr-TB), the issue of Hr-TB may go unnoticed. However, limited studies have focused on the clinical treatment of Hr-TB in China, particularly regarding treatment outcomes and influencing factors. This study aimed to evaluate the treatment outcomes of Hr-TB patients in Shanghai from 2018 to 2021 and analyze the influencing factors, including demographic characteristics, clinical features, and treatment-related factors.

Methods: This study retrospectively reviewed the medical records of Hr-TB patients registered in the TB management information system (TBMIS) from 2018 to 2021. Differences in demographic characteristics, clinical information, and treatment outcomes were evaluated. Multivariable logistic regression was used to identify risk factors associated with unfavorable outcomes.

Results: A total of 664 patients with Hr-TB were included in the analysis. 84 cases (12.7%) had unfavorable outcomes. Only 318 (47.9%) Hr-TB patients used regimens containing fluoroquinolones (FQs). Adverse events occurred in 127 cases (19.1%), of which 12 cases (1.81%) discontinued treatment due to adverse events. There was statistically significant difference in the occurrence of adverse events between the different treatment regimens (P<0.001). Multivariable logistic regression showed that older age (aOR=6.13, 95%CI=1.24-30.24, p=0.026), use of injectable agents (aOR=3.75, 95%CI=1.29-10.94, p=0.016), and treatment duration (95%CI=21.85-1487.61, p<0.001) were risk factors for unfavorable treatment outcomes.

Conclusion: Unfavorable outcomes were more frequent among older patients and those receiving injectable agents among Hr-TB patients in Shanghai, a low-endemic region for TB. This emphasizes the need for timely diagnosis and optimized treatment strategies for isoniazid-resistant tuberculosis.

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中国上海耐异烟肼肺结核患者的治疗结果及导致不良结果的关键因素。

目标：鉴于每年有 100 多万人罹患耐异烟肼结核病（Hr-TB），Hr-TB 的问题可能会被忽视。然而，有关中国耐异烟肼肺结核临床治疗的研究，尤其是有关治疗效果和影响因素的研究十分有限。本研究旨在评估2018年至2021年上海肺结核患者的治疗效果，并分析其影响因素，包括人口学特征、临床特征和治疗相关因素：本研究回顾性回顾了2018年至2021年在结核病管理信息系统（TBMIS）中登记的Hr-TB患者的病历。评估了人口统计学特征、临床信息和治疗结果的差异。采用多变量逻辑回归确定与不利结局相关的风险因素：共有 664 例肺结核患者纳入分析。84例（12.7%）患者出现不良预后。只有 318 例（47.9%）肺结核患者使用了含氟喹诺酮类药物（FQs）的治疗方案。有 127 例（19.1%）发生了不良反应，其中 12 例（1.81%）因不良反应而中断治疗。不同治疗方案的不良反应发生率在统计学上存在显著差异（PC结论：不同治疗方案的不良反应发生率存在显著差异：在上海这个结核病低流行地区，老年结核病患者和接受注射剂治疗的结核病患者更容易出现不良反应。这强调了及时诊断和优化耐异烟肼结核病治疗策略的必要性。

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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来源期刊

Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

8.70

自引率

2.20%

发文量

285

审稿时长

34 weeks

期刊介绍： The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.