Multidrug- and extensively drug-resistant tuberculosis

Eker, B; Ortmann, J; Migliori, GB; Sotgiu, G; Muetterlein, R; Centis, R; Hoffmann, H; Kirsten, D; Schaberg, T; Ruesch-Gerdes, S; Lange, C (2008). Multidrug- and extensively drug-resistant tuberculosis. Emerging infectious diseases, 11(14), pp. 1700-1706. Atlanta, Ga.: U.S. National Center for Infectious Diseases 10.3201/eid1411.080729

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We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004–2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean ± SD 202 ± 130 vs. 123 ± 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB.

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