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Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014
Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome. Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to id...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Centre for Disease Prevention and Control (ECDC)
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440580/ https://www.ncbi.nlm.nih.gov/pubmed/30914081 http://dx.doi.org/10.2807/1560-7917.ES.2019.24.12.1800392 |
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author | Karo, Basel Kohlenberg, Anke Hollo, Vahur Duarte, Raquel Fiebig, Lena Jackson, Sarah Kearns, Cathriona Ködmön, Csaba Korzeniewska-Kosela, Maria Papaventsis, Dimitrios Solovic, Ivan van Soolingen, Dick van der Werf, Marieke J. |
author_facet | Karo, Basel Kohlenberg, Anke Hollo, Vahur Duarte, Raquel Fiebig, Lena Jackson, Sarah Kearns, Cathriona Ködmön, Csaba Korzeniewska-Kosela, Maria Papaventsis, Dimitrios Solovic, Ivan van Soolingen, Dick van der Werf, Marieke J. |
author_sort | Karo, Basel |
collection | PubMed |
description | Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome. Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB. Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries. Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2). Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB. |
format | Online Article Text |
id | pubmed-6440580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | European Centre for Disease Prevention and Control (ECDC) |
record_format | MEDLINE/PubMed |
spelling | pubmed-64405802019-08-08 Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 Karo, Basel Kohlenberg, Anke Hollo, Vahur Duarte, Raquel Fiebig, Lena Jackson, Sarah Kearns, Cathriona Ködmön, Csaba Korzeniewska-Kosela, Maria Papaventsis, Dimitrios Solovic, Ivan van Soolingen, Dick van der Werf, Marieke J. Euro Surveill Research Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome. Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB. Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries. Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2). Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB. European Centre for Disease Prevention and Control (ECDC) 2019-03-21 /pmc/articles/PMC6440580/ /pubmed/30914081 http://dx.doi.org/10.2807/1560-7917.ES.2019.24.12.1800392 Text en This article is copyright of the authors or their affiliated institutions, 2019. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. |
spellingShingle | Research Karo, Basel Kohlenberg, Anke Hollo, Vahur Duarte, Raquel Fiebig, Lena Jackson, Sarah Kearns, Cathriona Ködmön, Csaba Korzeniewska-Kosela, Maria Papaventsis, Dimitrios Solovic, Ivan van Soolingen, Dick van der Werf, Marieke J. Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title | Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title_full | Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title_fullStr | Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title_full_unstemmed | Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title_short | Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014 |
title_sort | isoniazid (inh) mono-resistance and tuberculosis (tb) treatment success: analysis of european surveillance data, 2002 to 2014 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440580/ https://www.ncbi.nlm.nih.gov/pubmed/30914081 http://dx.doi.org/10.2807/1560-7917.ES.2019.24.12.1800392 |
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