Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis
Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB) with regard to treatment outcomes and antimicrobial susceptibility testing (ST) profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them h...
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ftdoajarticles:oai:doaj.org/article:08e373e7cb4b48d18e56b0d5816941ad 2023-05-15T15:12:42+02:00 Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis Bruno Horta Andrade Dirceu Bartolomeu Greco Maria Tereza da Costa Oliveira Natalia Priscila Lacerda Ricardo de Amorim Correa 2013-08-01T00:00:00Z https://doi.org/10.1590/0037-8682-0047-2013 https://doaj.org/article/08e373e7cb4b48d18e56b0d5816941ad EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000400441&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0047-2013 https://doaj.org/article/08e373e7cb4b48d18e56b0d5816941ad Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 4, Pp 441-446 (2013) Pulmonary tuberculosis Retreatment Drug resistance Antimicrobial susceptibility testing Treatment outcome Arctic medicine. Tropical medicine RC955-962 article 2013 ftdoajarticles https://doi.org/10.1590/0037-8682-0047-2013 2022-12-31T02:54:56Z Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB) with regard to treatment outcomes and antimicrobial susceptibility testing (ST) profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them had undergone prior treatment, were smear-positive for TB and received a standardized retreatment regimen. Fisher's 2-tailed exact test and the χ2 test were used; RRs and 95% CIs were calculated using univariate and multivariate binary logistic regression. Results The patients were cured in 84 (58.3%) cases. Failure was associated with relapsed treatment and abandonment (n=34). Culture tests were obtained for 103 (71.5%) cases; 70 (48.6%) had positive results. ST results were available for 67 (46.5%) cases; the prevalence of acquired resistance was 53.7%. There were no significant differences between those who achieved or not therapeutic success (p=0.988), despite being sensitive or resistant to 1 or more drugs. Rifampicin resistance was independently associated with therapeutic failure (OR: 4.4, 95% CI:1.12-17.37, p=0.034). For those cases in which cultures were unavailable, a 2nd model without this information was built. In this, return after abandonment was significantly associated with retreatment failure (OR: 3.59, 95% CI:1.17-11.06, p=0.026). Conclusions In this cohort, the general resistance profile appeared to have no influence on treatment outcome, except in cases of rifampicin resistance. The form of reentry was another independent predictor of failure. The use of bacterial culture identification and ST in TB management must be re-evaluated. The recommendations for different susceptibility profiles must also be improved. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 46 4 441 446 |
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English |
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Pulmonary tuberculosis Retreatment Drug resistance Antimicrobial susceptibility testing Treatment outcome Arctic medicine. Tropical medicine RC955-962 |
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Pulmonary tuberculosis Retreatment Drug resistance Antimicrobial susceptibility testing Treatment outcome Arctic medicine. Tropical medicine RC955-962 Bruno Horta Andrade Dirceu Bartolomeu Greco Maria Tereza da Costa Oliveira Natalia Priscila Lacerda Ricardo de Amorim Correa Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
topic_facet |
Pulmonary tuberculosis Retreatment Drug resistance Antimicrobial susceptibility testing Treatment outcome Arctic medicine. Tropical medicine RC955-962 |
description |
Introduction This study evaluated the efficacy of retreatment of pulmonary tuberculosis (TB) with regard to treatment outcomes and antimicrobial susceptibility testing (ST) profiles. Methods This retrospective cohort study analyzed 144 patients treated at a referral hospital in Brazil. All of them had undergone prior treatment, were smear-positive for TB and received a standardized retreatment regimen. Fisher's 2-tailed exact test and the χ2 test were used; RRs and 95% CIs were calculated using univariate and multivariate binary logistic regression. Results The patients were cured in 84 (58.3%) cases. Failure was associated with relapsed treatment and abandonment (n=34). Culture tests were obtained for 103 (71.5%) cases; 70 (48.6%) had positive results. ST results were available for 67 (46.5%) cases; the prevalence of acquired resistance was 53.7%. There were no significant differences between those who achieved or not therapeutic success (p=0.988), despite being sensitive or resistant to 1 or more drugs. Rifampicin resistance was independently associated with therapeutic failure (OR: 4.4, 95% CI:1.12-17.37, p=0.034). For those cases in which cultures were unavailable, a 2nd model without this information was built. In this, return after abandonment was significantly associated with retreatment failure (OR: 3.59, 95% CI:1.17-11.06, p=0.026). Conclusions In this cohort, the general resistance profile appeared to have no influence on treatment outcome, except in cases of rifampicin resistance. The form of reentry was another independent predictor of failure. The use of bacterial culture identification and ST in TB management must be re-evaluated. The recommendations for different susceptibility profiles must also be improved. |
format |
Article in Journal/Newspaper |
author |
Bruno Horta Andrade Dirceu Bartolomeu Greco Maria Tereza da Costa Oliveira Natalia Priscila Lacerda Ricardo de Amorim Correa |
author_facet |
Bruno Horta Andrade Dirceu Bartolomeu Greco Maria Tereza da Costa Oliveira Natalia Priscila Lacerda Ricardo de Amorim Correa |
author_sort |
Bruno Horta Andrade |
title |
Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
title_short |
Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
title_full |
Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
title_fullStr |
Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
title_full_unstemmed |
Contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
title_sort |
contributions of culture and antimicrobial susceptibility tests to the retreatment of patients with pulmonary tuberculosis |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2013 |
url |
https://doi.org/10.1590/0037-8682-0047-2013 https://doaj.org/article/08e373e7cb4b48d18e56b0d5816941ad |
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Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 4, Pp 441-446 (2013) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000400441&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0047-2013 https://doaj.org/article/08e373e7cb4b48d18e56b0d5816941ad |
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https://doi.org/10.1590/0037-8682-0047-2013 |
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46 |
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