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Outcome of culture-confirmed isoniazid-resistant rifampicin-susceptible tuberculosis in children.
Garcia-Prats, A J; du Plessis, L; Draper, H R; Burger, A; Seddon, J A; Zimri, K; Hesseling, A C; Schaaf, H S.
Afiliación
  • Garcia-Prats AJ; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • du Plessis L; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • Draper HR; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • Burger A; Brewelskloof Hospital, Western Cape Government Department of Health, Worcester, South Africa.
  • Seddon JA; Department of Paediatrics, Imperial College London, London, UK.
  • Zimri K; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • Hesseling AC; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
  • Schaaf HS; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Int J Tuberc Lung Dis ; 20(11): 1469-1476, 2016 11.
Article en En | MEDLINE | ID: mdl-27776587
SETTING: Isoniazid-resistant rifampicin-susceptible (HRRS) tuberculosis (TB) is the most prevalent form of drug-resistant TB globally, and may be a risk factor for poor outcomes, but has been poorly described in children. OBJECTIVE: To characterise the clinical presentation, treatment, and clinical and microbiological outcomes among children with culture-confirmed HRRS TB. DESIGN: Retrospective hospital-based cohort study. RESULTS: Of the 72 children included in the study, the median age was 50.1 months (IQR 21.5-102.5); 42% were male. Forty-four (51%) had a potential source case; only 13 were confirmed HRRS TB. Of 66 tested, 12 (17%) were human immunodeficiency virus (HIV) infected, and 36 (60%) of the 60 with pulmonary TB (PTB) had severe disease. Seventy children had treatment data; the median total duration of treatment was 11.3 months (IQR 9-12.3); 25 (36%) initiated treatment with a three-drug intensive phase; 52 (74%) received a fluoroquinolone. Of 63 children with known outcomes, 55 (88%) had a favourable outcome, 1 died and 3 had treatment failure. Ten had positive follow-up cultures at ⩾2 months after starting treatment. Older age (P = 0.008), previous anti-tuberculosis treatment (P = 0.023) and severe PTB (P = 0.018) were associated with failure to culture-convert at ⩾2 months. CONCLUSIONS: Although overall outcomes were good, prolonged culture positivity and cases of treatment failure emphasise the need for additional attention to the management of children with HRRS TB.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rifampin / Tuberculosis Pulmonar / Tuberculosis Resistente a Múltiples Medicamentos / Farmacorresistencia Bacteriana Múltiple / Isoniazida Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2016 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Francia
Buscar en Google
Añadir a Mi BVS
Imprimir
XML
PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rifampin / Tuberculosis Pulmonar / Tuberculosis Resistente a Múltiples Medicamentos / Farmacorresistencia Bacteriana Múltiple / Isoniazida Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2016 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Francia