RESUMEN
BACKGROUND: The quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) effectively detects the SARS-COV-2 virus. SARS-CoV-2 Nevertheless, some critical gaps remain in the identification and monitoring of asymptomatic people. METHODS: This retrospective study included 733 asymptomatic and symptomatic COVID-19 subjects, who were submitted to the RT-qPCR test. The objective was to assess the efficacy of an expanded triage of subjects undergoing the RT-qPCR test for SARS-COV-2 to identify the largest possible number of COVID-19 cases in a hospital setting in Ecuador. SARS-CoV-2 Firstly, the sensitivity and specificity as well as the predictive values of an expanded triage method were calculated. In addition, the Kappa coefficient was also determined to assess the concordance between laboratory test results and the expanded triage. RESULTS: Of a total of 733 sputum samples; 229 were RT-qPCR-positive (31.2%) and mortality rate reached 1.2%. Overall sensitivity and specificity were 86.0% (95% confidence interval: 81.0-90.0%) and 37.0% (95% confidence interval: 32.0-41.0%) respectively, with a diagnostic accuracy of 52.0% and a Kappa coefficient of 0.73. An association between the positivity of the test and its performance before 10 days was found. CONCLUSIONS: The clinical sensitivity for COVID-19 detection was within acceptable standards, but the specificity still fell below the values of reference. The lack of symptoms did not always mean to have a negative SARS-COV-2 RT-qPCR test. The expanded triage identified a still unnoticed percentage of asymptomatic subjects showing positive results for the SARS-COV-2 RT-qPCR test. The study also revealed a significant relationship between the number of RT-qPCR-positive cases and the performance of the molecular diagnosis within the first 10 days of COVID-19 in the symptomatic group.
Asunto(s)
Prueba de COVID-19 , COVID-19/diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , SARS-CoV-2 , Esputo/virología , Ecuador , Humanos , Estudios Retrospectivos , SARS-CoV-2/genética , SARS-CoV-2/aislamiento & purificación , Sensibilidad y Especificidad , TriajeRESUMEN
Management of SARS-CoV-2 requires safe decision-making to minimize contamination. Healthcare workers and professionals in confined areas are affected by the risk of the activity and the environment. Isolation of contaminated workers and healthcare professionals requires clinical and diagnostic criteria. On the other hand, interrupting the isolation of healthcare employees and professionals is critical because diagnostic tests do not support clinical decisions. In addition to defining the best test in view of its accuracy, it is necessary to consider aspects such as the stage of the disease or cure, the viral load and the individual's own immunity. Uncertainty about natural and herd immunity to the disease leads to the development of appropriate antivirals, diagnostic tests and vaccines.
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Prueba de Ácido Nucleico para COVID-19 , Prueba Serológica para COVID-19 , COVID-19/transmisión , Aislamiento de Pacientes/normas , Inmunidad Adaptativa/inmunología , Anticuerpos Antivirales/inmunología , Antígenos Virales/inmunología , Líquido del Lavado Bronquioalveolar/química , Líquido del Lavado Bronquioalveolar/virología , COVID-19/diagnóstico , COVID-19/inmunología , COVID-19/prevención & control , Prueba de COVID-19 , Toma de Decisiones Clínicas , Heces/química , Heces/virología , Personal de Salud , Humanos , Inmunoglobulina G/inmunología , Inmunoglobulina M/inmunología , Nasofaringe/química , Nasofaringe/virología , Aislamiento de Pacientes/métodos , ARN Viral/análisis , SARS-CoV-2 , Esputo/química , Esputo/virología , Carga ViralRESUMEN
OBJECTIVE: Multidrug-resistant tuberculosis (MDR-TB) remains a serious public health problem worldwide. Accordingly, this study sought to identify individual, community and access to health services risk factors for MDR-TB. METHODS: Retrospective cohort of all TB cases diagnosed between 2006 and 2016 in the state of São Paulo. A Bayesian spatial hierarchical analysis with a multilevel design was carried out. RESULTS: It was identified that the history of previous TB treatment (Odds Ratios [OR]:13.86, 95% credibility interval [95% CI]:12.06-15.93), positive sputum culture test (OR: 5.26, 95% CI: 4.44-6.23), diabetes mellitus (OR: 2.34, 95% CI: 1.87-2.91), residing at a standard address (OR: 2.62, 95% CI: 1.91-3.60), positive sputum smear microscopy (OR: 1.74, 95% CI: 1.44-2.12), cavitary pulmonary TB (OR: 1.35, 95% CI: 1.14-1.60) and diagnosis performed due to spontaneous request (OR: 1.26; 95% CI: 1.10-1.46) were associated with MDR-TB. Furthermore, municipalities that performed HIV tests in less than 42.65% of patients with TB (OR: 1.50, 95% CI: 1.25-1.79), that diagnosed TB cases only after death (OR: 1.50, 95% CI: 1.17-1.93) and that had more than 20.16% of their population with income between » and ½ of one minimum wage (OR: 1.56, 95% CI: 1.30-1.87) were also related to the MDR-TB. CONCLUSIONS: Knowledge of these predictive factors may help to develop more comprehensive disease prevention strategies for MDR-TB, avoiding the risks expressed regarding drug resistance expansion.
OBJECTIF: La tuberculose multirésistante (TB-MDR) reste un grave problème de santé publique dans le monde. Cette étude visait à identifier les facteurs de risque individuels, communautaires et d'accès aux services de santé pour la TB-MDR. MÉTHODES: Analyse de cohorte rétrospective de tous les cas de TB diagnostiqués entre 2006 et 2016 dans l'Etat de São Paulo par analyse bayésienne spatiale à plusieurs niveaux. RÉSULTATS: Les antécédents de traitements antituberculeux (Rapports de cotes [OR]: 13,86, Intervalle de confiance à 95% [IC95%]: 12.06-15.93), un test de culture d'expectorations positif (OR: 5,26, IC95%: 4,44-6,23), le diabète sucré (OR: 2,34, IC95%: 1,87-2,91), la résidence à une adresse standard (OR: 2,62, IC95%: 1,91-3,60), la microscopie à frottis positif (OR: 1,74, IC95%: 1,44-2,12), la TB pulmonaire (OR: 1,35, IC95%: 1,14-1,60) et le diagnostic réalisé en raison d'une demande spontanée (OR: 1,26; IC95%: 1,10-1,46) étaient associés à la TB-MDR. Les municipalités qui ont effectué des tests de dépistage du VIH chez moins de 42,65% des patients atteints de TB (OR: 1,50, IC95%: 1,25-1,79), qui ont diagnostiqué des cas de TB uniquement après le décès (OR: 1,50, IC95%: 1,17-1,93) et qui avaient plus de 20,16% de leur population avec un revenu entre » et ½ d'un salaire minimum (OR: 1,56, IC95%: 1,30-1,87) étaient également associées à la TB-MDR. CONCLUSIONS: La connaissance de ces facteurs prédictifs peut aider à développer des stratégies plus complètes de prévention des maladies pour la TB-MDR, en évitant les risques d'extension de la résistance aux médicaments.
Asunto(s)
Infecciones por VIH/microbiología , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Resistente a Múltiples Medicamentos/virología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antituberculosos/farmacología , Teorema de Bayes , Brasil/epidemiología , Femenino , Infecciones por VIH/epidemiología , Humanos , Modelos Logísticos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/aislamiento & purificación , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos , Esputo/microbiología , Esputo/virología , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Adulto JovenRESUMEN
Cultura de micobactérias proporciona o crescimento de bacilos viáveis, mesmo presentes em escassa quantidade e não detectados pela baciloscopia. Neste estudo foram analisadas as amostras de escarro que apresentaram baciloscopia negativa e cultura positiva. As amostras foram coletadas de 2008 a 2013, de indivíduos detidos em Centros de Detenção Provisória de Santo André, Mauá e Diadema, Estado de São Paulo. As metodologias utilizadas foram baciloscopia por coloração Ziehl-Neelsen e cultura pelo Sistema BACTEC MGIT 960 e Ogawa-Kudoh. Dos 11.529 exames realizados, 221 (1,9 %) apresentaram baciloscopias negativas e culturas positivas. Dos 221 isolados, 166 (75,1 %) pertenciam ao Complexo Mycobacterium tuberculosis, 21 (9,5 %) micobactérias não membros do Complexo Mycobacterium tuberculosis (MNT), 33 (14,9 %) Mycobaterium sp e uma cultura mista do Complexo M. tuberculosis e M. avium. MNT mais frequentes foram M. avium (23,8 %) e M. fortuitum (19,0 %). A maioria dos isolados do Complexo M. tuberculosis (155/166 - 93,4 %) foi sensível aos antimicrobianos. Sete amostras apresentaram resistência à isoniazida e uma apresentou multirresistência à isoniazida e rifampicina. Este estudo mostra a importância da realização da cultura em escarros que apresentam baciloscopia negativa no diagnóstico da TB e micobacteriose. O tratamento tardio causa a continuidade da transmissão da doença e agravamento do quadro clínico.
Culture of mycobacteria induces the growth of viable bacillus occurring in small quantity, which are no detectable by bacilloscopy. This study aimed at identifying the mycobacteria isolates from sputum presenting negative bacilloscopy and positive culture. The samples were collected from 2008 to 2013 from criminals of Provisional Detention Centers in Santo André, Mauá and Diadema/SP. Smears were stained by Ziehl-Neelsen staining and the cultures were performed by the BACTEC MGIT 960 system and Ogawa-Kudoh culture medium. Of 11,529 isolates, 221 (1.9 %) showed negative bacilloscopy and positive cultures. Of 221 isolates, 166 (75.1 %) belonged to Mycobacterium tuberculosis complex, 21 (9.5 %) were nontuberculous mycobacteria (NTM), 33 (14.9 %) Mycobacterium sp, and one identified as a mixed culture of M. tuberculosis and M. avium complex. The most common NTM species were M. avium (23.8 %) and M. fortuitum (19.0 %). Most of the isolates (155/166-93.4 %) were susceptible to antimicrobial agents. Seven samples were resistant to isoniazid, and one presented multiresistance to isoniazid and rifampicin. This study shows the importance in performing sputum culture, when these samples are negative on bacilloscopy in diagnosing TB and mycobacteriosis. The treatment delay results in the maintenance of disease transmission and worsening of clinical symptoms.
Asunto(s)
Esputo/virología , Mycobacterium tuberculosis , Prisiones , Tuberculosis Pulmonar/diagnóstico , Cultivo de Virus , Técnicas de CultivoRESUMEN
Cultura de micobactérias proporciona o crescimento de bacilos viáveis, mesmo presentes em escassa quantidade e não detectados pela baciloscopia. Neste estudo foram analisadas as amostras de escarro que apresentaram baciloscopia negativa e cultura positiva. As amostras foram coletadas de 2008 a 2013, de indivíduos detidos em Centros de Detenção Provisória de Santo André, Mauá e Diadema, Estado de São Paulo. As metodologias utilizadas foram baciloscopia por coloração Ziehl-Neelsen e cultura pelo Sistema BACTEC MGIT 960 e Ogawa-Kudoh. Dos 11.529 exames realizados, 221 (1,9 %) apresentaram baciloscopias negativas e culturas positivas. Dos 221 isolados, 166 (75,1 %) pertenciam ao Complexo Mycobacterium tuberculosis, 21 (9,5 %) micobactérias não membros do Complexo Mycobacterium tuberculosis (MNT), 33 (14,9 %) Mycobaterium sp e uma cultura mista do Complexo M. tuberculosis e M. avium. MNT mais frequentes foram M. avium (23,8 %) e M. fortuitum (19,0 %). A maioria dos isolados do Complexo M. tuberculosis (155/166 - 93,4 %) foi sensível aos antimicrobianos. Sete amostras apresentaram resistência à isoniazida e uma apresentou multirresistência à isoniazida e rifampicina. Este estudo mostra a importância da realização da cultura em escarros que apresentam baciloscopia negativa no diagnóstico da TB e micobacteriose. O tratamento tardio causa a continuidade da transmissão da doença e agravamento do quadro clínico.(AU)
Culture of mycobacteria induces the growth of viable bacillus occurring in small quantity, which are no detectable by bacilloscopy. This study aimed at identifying the mycobacteria isolates from sputum presenting negative bacilloscopy and positive culture. The samples were collected from 2008 to 2013 from criminals of Provisional Detention Centers in Santo André, Mauá and Diadema/SP. Smears were stained by Ziehl-Neelsen staining and the cultures were performed by the BACTEC MGIT 960 system and Ogawa-Kudoh culture medium. Of 11,529 isolates, 221 (1.9 %) showed negative bacilloscopy and positive cultures. Of 221 isolates, 166 (75.1 %) belonged to Mycobacterium tuberculosis complex, 21 (9.5 %) were nontuberculous mycobacteria (NTM), 33 (14.9 %) Mycobacterium sp, and one identified as a mixed culture of M. tuberculosis and M. avium complex. The most common NTM species were M. avium (23.8 %) and M. fortuitum (19.0 %). Most of the isolates (155/166-93.4 %) were susceptible to antimicrobial agents. Seven samples were resistant to isoniazid, and one presented multiresistance to isoniazid and rifampicin. This study shows the importance in performing sputum culture, when these samples are negative on bacilloscopy in diagnosing TB and mycobacteriosis. The treatment delay results in the maintenance of disease transmission and worsening of clinical symptoms.(AU)
Asunto(s)
Tuberculosis Pulmonar/diagnóstico , Esputo/virología , Prisiones , Mycobacterium tuberculosis , Técnicas de Cultivo , Cultivo de VirusRESUMEN
BACKGROUND: Adult community-acquired pneumonia (CAP) is a relevant worldwide cause of morbidity and mortality, however the aetiology often remains uncertain and the therapy is empirical. We applied conventional and molecular diagnostics to identify viruses and atypical bacteria associated with CAP in Chile. METHODS: We used sputum and blood cultures, IgG/IgM serology and molecular diagnostic techniques (PCR, reverse transcriptase PCR) for detection of classical and atypical bacteria (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumoniae) and respiratory viruses (adenovirus, respiratory syncytial virus (RSV), human metapneumovirus, influenza virus, parainfluenzavirus, rhinovirus, coronavirus) in adults >18 years old presenting with CAP in Santiago from February 2005 to September 2007. Severity was qualified at admission by Fine's pneumonia severity index. RESULTS: Overall detection in 356 enrolled adults were 92 (26%) cases of a single bacterial pathogen, 80 (22%) cases of a single viral pathogen, 60 (17%) cases with mixed bacterial and viral infection and 124 (35%) cases with no identified pathogen. Streptococcus pneumoniae and RSV were the most common bacterial and viral pathogens identified. Infectious agent detection by PCR provided greater sensitivity than conventional techniques. To our surprise, no relationship was observed between clinical severity and sole or coinfections. CONCLUSIONS: The use of molecular diagnostics expanded the detection of viruses and atypical bacteria in adults with CAP, as unique or coinfections. Clinical severity and outcome were independent of the aetiological agents detected.
Asunto(s)
Bacterias/genética , Infecciones Comunitarias Adquiridas/epidemiología , Técnicas de Diagnóstico Molecular/métodos , Neumonía Bacteriana/epidemiología , Neumonía Viral/epidemiología , Virus/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Chile/epidemiología , Infecciones Comunitarias Adquiridas/diagnóstico , ADN Bacteriano/análisis , ADN Viral/análisis , Diagnóstico Diferencial , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/diagnóstico , Neumonía Bacteriana/microbiología , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Esputo/microbiología , Esputo/virología , Adulto JovenRESUMEN
El paciente con enfermedades oncológicas tiene un alto riesgo para desarrollar infecciones respiratorias, y neumonía por Pneumocystis jirovecii. En Venezuela existen pocos estudios sobre la neumocistosis en pacientes oncológicos. El objetivo de este trabajo fue detectar la presencia de Pneumocystis jirovecii en pacientes oncológicos a través de la técnica de inmunofluorescencia directa. Se recibieron, durante 10 meses, 31 muestras respiratorias (lavado broncoalveolar, esputo espontáneo e inducido, aspirados traqueales), de ellas 8 (25,5 por ciento) resultaron positivas. La distribución por tipo de cáncer fue la siguiente: 18 tumores sólidos y 13 leucemias y linfomas. La positividad entre los grupos estudiados no fue estadísticamente significativa (P>0,05). Los exámenes de laboratorio complementarios, relacionados tampoco fueron estadísticamente significativos (P>0,05). Es necesario incluir este diagnóstico en estudio microbiológico diferencial de infecciones del tracto respiratorio inferior en pacientes con cáncer, estos pacientes cursan con una sintomatología general inespecífica y tendrán una alta posibilidad de desarrollar neumocistosis.
The patient with malignancy disease has a high risk to develop respiratory infections for Pneumocystis jirovecii pneumonia. Investigations about pneumocystosis in oncological patients in Venezuela are scarce. The objective of this work was to detect Pneumocystis jirovecii in oncological patients by the method of direct immunofluorescence technique. Thirty one respiratory specimens (bronchoalveolar lavage, spontaneous and induced sputum, and tracheal aspirates) received in 10 months, 8 specimens of them (25.5) were positive the distribution by malignancy disease was the following: 18 solid tumors, and 13 leukemias, and lymphomas. No statistically significant differences were found between the studied groups and positive results (P>0.05). The complementary laboratory tests, related to the presence of Pneumocystis, were not statistically significant either P>0.05). Is necessary to include this diagnosis in the microbiological differential study of low respiratory tract infections in oncological patients, since these patients show unspecific symptoms, and have a high possibility to develop pneumocystosis.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Leucemia/patología , Linfoma/patología , Neumonía por Pneumocystis/diagnóstico , Neumonía por Pneumocystis/etiología , Neumonía por Pneumocystis/patología , Sistema Respiratorio/patología , Técnica del Anticuerpo Fluorescente Directa/métodos , Esputo/virología , Infecciones Bacterianas/complicaciones , Lavado Broncoalveolar/métodosRESUMEN
Habitat fragmentation and diseases have resulted in a decline of the marsh deer (Blastocerus dichotomus) throughout its South American range. Our objectives were to determine whether marsh deer intended for translocation from a region of the Rio Paraná Basin had been infected previously by foot-and-mouth disease virus (FMDV) and whether they were carrying virus. We captured marsh deer from June to October 1998 and collected blood from 108 animals and esophageal-pharyngeal fluid from 53. Serum was tested for antibodies against three FMDV serotypes (O, A, and C) by liquid-phase-blocking sandwich enzyme-linked immunosorbent assay (ELISA). Esophageal-pharyngeal fluid was tested for FMDV RNA by reverse transcription polymerase chain reaction (RT-PCR) and inoculation into three successive baby hamster kidney (BHK-21) cell subcultures, followed by RT-PCR of cultures. We detected low log(10) titers (range 1.0-1.5) to FMDV subtype A(24) Cruzeiro in 19 of 108 sampled marsh deer, but failed to isolate FMDV or detect FMDV RNA in any samples. We conclude that marsh deer from our study site were unlikely to carry FMDV; however, as a preventive measure, the 19 animals with titers for FMDV were not sent to FMDV-free Brazilian states.
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Ciervos/virología , Virus de la Fiebre Aftosa/aislamiento & purificación , Fiebre Aftosa/epidemiología , Animales , Animales Salvajes/virología , Anticuerpos Antivirales/sangre , Brasil/epidemiología , Ecosistema , Especies en Peligro de Extinción , Femenino , Fiebre Aftosa/transmisión , Virus de la Fiebre Aftosa/clasificación , Virus de la Fiebre Aftosa/inmunología , Masculino , ARN Viral/análisis , Serotipificación/veterinaria , Esputo/virología , TransportesRESUMEN
UNLABELLED: OBJECTIVES AND WORKING HYPOTHESIS: To evaluate the prevalence of respiratory viruses Mycoplasma pneumoniae and Chlamydophila pneumoniae and gain insight into their seasonal circulation pattern in children with acute asthma exacerbations in a temperate southern hemisphere region. STUDY DESIGN: Patients hospitalized between 3 months and 16 years of age were included in a 1-year prospective, observational, cross-sectional study. Respiratory secretions were collected and the presence of different viruses and atypical bacteria analyzed by immunofluorescence and polymerase chain reaction. RESULTS: Two hundred nine patients (118 females) aged (mean +/- SD) 4.4 +/- 4 years were included. A potential causative agent was detected in 78% of the patients. The most frequently detected viruses were respiratory syncytial virus (HRSV) (n = 85; 40%) and rhinovirus (HRV) (n = 52; 24.5%); M. pneumoniae and C. pneumoniae were detected in 4.5% and 2% of the cases, respectively. Patients with HRSV (vs. HRV) were hospitalized for a longer time (6.7 vs. 5.2 days, P = 0.012), required more days of oxygen supply (5.1 vs. 3.4, P = 0.005), had a longer duration of the exacerbation before hospitalization (3.6 vs. 1.9 days, P = 0.001) and were younger (3.7 vs. 5.1 years, P = 0.012). Three peaks of admissions were observed. A first peak (early autumn) caused by HRV, a second peak (winter) caused mainly by HRSV and a third one (spring), caused by HRSV, an increase in HMPV together with a second outbreak of HRV. CONCLUSIONS: Children with an acute asthma exacerbation presented a high prevalence of respiratory viruses. Most hospitalizations corresponded to seasonal increases in prevalence of HRV and HRSV.
Asunto(s)
Asma/microbiología , Asma/patología , Adolescente , Asma/virología , Niño , Preescolar , Infecciones por Chlamydophila/complicaciones , Infecciones por Chlamydophila/diagnóstico , Chlamydophila pneumoniae/aislamiento & purificación , Estudios Transversales , Progresión de la Enfermedad , Femenino , Humanos , Lactante , Tiempo de Internación , Masculino , Mycoplasma pneumoniae/aislamiento & purificación , Terapia por Inhalación de Oxígeno , Infecciones por Picornaviridae/complicaciones , Infecciones por Picornaviridae/diagnóstico , Neumonía por Mycoplasma/complicaciones , Neumonía por Mycoplasma/diagnóstico , Estudios Prospectivos , Infecciones por Virus Sincitial Respiratorio/complicaciones , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Estaciones del Año , Esputo/microbiología , Esputo/virologíaRESUMEN
To investigate a possible role for human rhinovirus C in respiratory exacerbations of children with cystic fibrosis, we conducted microbiologic testing on respiratory specimens from 103 such patients in São Paulo, Brazil, during 2006-2007. A significant association was found between the presence of human rhinovirus C and respiratory exacerbations.
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Fibrosis Quística/complicaciones , Infecciones por Picornaviridae/etiología , Infecciones del Sistema Respiratorio/etiología , Rhinovirus/aislamiento & purificación , Adolescente , Brasil/epidemiología , Niño , Preescolar , Fibrosis Quística/epidemiología , Femenino , Humanos , Lactante , Masculino , Datos de Secuencia Molecular , Moco/virología , Nasofaringe/virología , Filogenia , Infecciones por Picornaviridae/epidemiología , ARN Viral/análisis , ARN Viral/genética , Infecciones del Sistema Respiratorio/epidemiología , Rhinovirus/genética , Análisis de Secuencia de ARN , Especificidad de la Especie , Esputo/virologíaRESUMEN
The effects of HIV co-infection and multi-drug resistant tuberculosis (MDRTB) on tuberculosis prognosis are poorly defined. Therefore, we studied infectiousness and mortality of 287 tuberculosis patients treated with standard, directly observed, short-course therapy in the Peruvian community. During 6-17 months of treatment, 49 (18%) of patients died, of whom 48 (98%) had AIDS and 28 (57%) had MDRTB; 17/31 (55%) of MDRTB-patients with AIDS died within 2 months of diagnosis, before traditional susceptibility testing would have identified their MDRTB. Most non-MDRTB became smear- and culture-negative within 6 weeks of therapy, whereas most MDRTB remained sputum-culture-positive until death or treatment completion. HIV-negative patients with non-MDRTB had good outcomes. However, MDRTB was associated with prolonged infectiousness and HIV co-infection with early mortality, indicating a need for greater access to anti-retroviral therapy. Furthermore, early and rapid tuberculosis drug-susceptibility testing and infection control are required so that MDRTB can be appropriately treated early enough to reduce mortality and transmission.