Adverse treatment outcomes in multidrug resistant tuberculosis go beyond the microbe-drug interaction: Results of a multiple correspondence analysis.

Ángela Tobón, Johana Rueda, Diego H. Cáceres , Gloria I. Mejía, Elsa M. Zapata, Fernando Montes, Antonio Ospina, Santiago Fadul, Lizeth Paniagua, Jaime Robledo, .

DOI: https://doi.org/10.7705/biomedica.5072
Keywords: Tuberculosis, multidrug-resistant, extensively drug-resistant tuberculosis, treatment outcome
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Abstract

Introduction: Multidrug-resistant tuberculosis treatment is effective in 50% of patients due to several factors including antibiotic susceptibility of the microorganism, adverse treatment reactions, social factors, and associated comorbidities.
Objectives: In this study, we describe the demographics, clinical characteristics, and factors associated with treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients in Medellín, Colombia.
Materials and methods: We conducted a retrospective analysis using data from patients diagnosed with MDR-TB attending Hospital La María in Medellín, Colombia, for treatment between 2010 and 2015. Patients were categorized as having successful (cured) or poor (failure, lost to follow-up, and death) treatment outcomes. Associations between demographic, clinical factors, laboratory results, treatment outcomes, and follow-up information were evaluated by univariate, multivariate, and multiple correspondence analyses.
Results: Of the 128 patients with MDR-TB, 77 (60%) had successful outcomes. Of those with poor outcomes, 26 were lost to follow-up, 15 died, and 10 were treatment failures. Irregular treatment, the presence of comorbidities, and positive cultures after more than two months of treatment were associated with poor outcomes compared to successful ones (p<0.05 for all). The multiple correspondence analyses grouped patients who were lost to follow-up, had HIV, and drug addiction, as well as patients with treatment failure, irregular treatment, and chronic obstructive pulmonary disease.
Conclusion: The recognition of factors affecting treatment is essential and was associated with treatment outcomes in this series of patients. Early identification of these factors should increase the rates of treatment success and contribute to MDR-TB control.

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  • Ángela Tobón Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia
  • Johana Rueda Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia
  • Diego H. Cáceres Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia
  • Gloria I. Mejía Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia
  • Elsa M. Zapata Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia
  • Fernando Montes Programa de Control de Tuberculosis, Secretaría de Salud del Municipio de Medellín, Medellín, Colombia
  • Antonio Ospina Programa de Control de Tuberculosis, Secretaría de Salud del Municipio de Medellín, Medellín, Colombia
  • Santiago Fadul Grupo de Transmisibles – Equipo de Respiratorias, División de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombiambia
  • Lizeth Paniagua Programa de Control de Tuberculosis, Secretaría de Salud y Protección Social de Antioquia, Medellín, Colombia
  • Jaime Robledo Unidades de Bacteriología y Micobacterias y Micología Médica y Experimental, Corporación para Investigaciones Biológicas, Medellín, Colombia; Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia

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How to Cite
1.
Tobón Ángela, Rueda J, Cáceres DH, Mejía GI, Zapata EM, Montes F, et al. Adverse treatment outcomes in multidrug resistant tuberculosis go beyond the microbe-drug interaction: Results of a multiple correspondence analysis. biomedica [Internet]. 2020 Dec. 2 [cited 2024 May 21];40(4):616-25. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/5072

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Published
2020-12-02
Issue
Vol. 40 No. 4 (2020)
Section
Original articles

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