Lethal Drug-resistant TB Deadlier Than Previously Thought

Extensively drug-resistant tuberculosis (XDR-TB) is increasingly common and deadlier than previously thought.

A new study has revealed that extensively drug-resistant tuberculosis (XDR-TB) is increasingly common and deadlier than previously thought.

The study compared patients with XDR-TB to individuals with other types of multi-drug-resistant TB (MDR-TB), and showed that those with the former condition were four times as likely to fail treatment and three times more likely to die.

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Published in the American Journal of Respiratory and Critical Care Medicine, the study also found that MDR-TB was "a major threat to public health," representing 2.7 percent of new TB cases in South Korea in 2004, up from 1.6 percent in 1994.

"Treatment outcomes (of XDR-TB)have varied among studies, and data on long-term survival are still scarce," wrote Dr. Tae Sun Shim, an associate professor at Asan Medical Center in Seoul, South Korea, and a principal investigator of the study.

"(This) is the largest report that we know of that compares patients with XDR-TB with other patients with MDR-TB to determine the impact of XDR-TB on treatment outcomes and long-term survival in mostly HIV-negative patients with MDR-TB," Dr. Shim wrote.

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The researchers reviewed the medical records of more than 1,400 patients in South Korea with MDR-TB (which includes XDR-TB) from all national hospitals, Korean National TB Association chest clinics and select university hospitals. The patients' history of TB and previous treatments were also noted.

In this study, XDR-TB was defined as MDR-TB resistant to both ofloxacin and at least one second-line injectable drug.

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According to the researchers, patients with XDR-TB were significantly older than MDR-TB patients, more likely to have a history of treatment with second-line TB drugs, and more likely to have a history of being treated for TB two or more times.

They said that treatment failure among that population was much more common when compared to other patients with MDR-TB.

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They further observed that relapse rate among "cured" patients also tended to be higher among patients with XDR-TB, the difference was not statistically significant.

"(Having) XDR-TB was the strongest predictor of both all-cause and TB-related mortality, and survival curves showed higher cumulative mortality among patients with XDR-TB than in other patients with MDR-TB," wrote Dr. Shim.

The researchers said that only through further research and concerted effort to understand and quantify the effects of the disease could really prevent MDR- and XDR-TB from becoming pandemic health crises.

"As we wait for new diagnostics and drugs that can meet the challenge of XDR-TB, we must work with what we presently have to create the optimal conditions for success and thus seize the opportunity we have to eliminate tuberculosis," they concluded.

Source-ANI
SPH