Risk Factors for Acquisition of Drug Resistance during Multidrug-Resistant Tuberculosis Treatment, Arkhangelsk Oblast, Russia, 2005–2010

• Published in: Emerging Infectious Diseases
• Main Authors: Sarah E. Smith, Julia Ershova, Natalia Vlasova, Elena Nikishova, Irina Tarasova, Platon Eliseev, Andrey Maryandyshev, Igor G. Shemyakin, Ekaterina V. Kurbatova, J. Peter Cegielski
• Format: Article in Journal/Newspaper
• Language: English
• Published: Centers for Disease Control and Prevention 2015
• Subjects: tuberculosis and other mycobacteria; antimicrobial drug resistance; Russia; acquired drug resistance; risk factors; antimicrobial resistance; Medicine; R; Infectious and parasitic diseases; RC109-216; Arkhangelsk; Arkhangelsk Oblast
• Online Access: https://doi.org/10.3201/eid2106.141907; https://doaj.org/article/b85179134aaa4c1791e2e8d9b2095ed8

Acquired resistance to antituberculosis drugs decreases effective treatment options and the likelihood of treatment success. We identified risk factors for acquisition of drug resistance during treatment for multidrug-resistant tuberculosis (MDR TB) and evaluated the effect on treatment outcomes. Data were collected prospectively from adults from Arkhangelsk Oblast, Russia, who had pulmonary MDR TB during 2005–2008. Acquisition of resistance to capreomycin and of extensively drug-resistant TB were more likely among patients who received <3 effective drugs than among patients who received >3 effective drugs (9.4% vs. 0% and 8.6% vs. 0.8%, respectively). Poor outcomes were more likely among patients with acquired capreomycin resistance (100% vs. 25.9%), acquired ofloxacin resistance (83.6% vs. 22.7%), or acquired extensive drug resistance (100% vs. 24.4%). To prevent acquired drug resistance and poor outcomes, baseline susceptibility to first- and second-line drugs should be determined quickly, and treatment should be adjusted to contain >3 effective drugs.