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Risk factors associated with fluoroquinolone-resistant tuberculosis in a Beijing tuberculosis referral hospital
Cui Hua Liu1, Nan Yang, Qi Wang
1Institute for Tuberculosis Research, The 309 Hospital, Beijing, China. cuihualiu@gmail.com
Background And Objective:
The rapid increase in the number of multi-drug-resistant tuberculosis (MDR-TB) cases worldwide emphasizes the importance of rational use of key important life-saving second-line anti-TB drugs such as fluoroquinolones. In order to provide information for better case management, so as to minimize the further spread of extensively drug-resistant TB, a retrospective study was performed to assess the risk factors associated with fluoroquinolone resistance among TB patients attending the 309 Hospital in Beijing, China.
Methods:
Drug susceptibility testing results and clinical data for hospitalized TB patients for the period 2000-2010 were analysed. Univariate and multivariate analyses were used to determine the risk factors associated with fluoroquinolone-resistant TB.
Results:
From July 2000 to July 2010, ofloxacin resistance was observed in 306 of 3546 (8.6%) hospitalized TB patients who were tested. The independent risk factors associated with fluoroquinolone-resistant TB were being single (adjusted OR 1.65), being a migrant living in Beijing (adjusted OR 2.15), being a migrant from another area (adjusted OR 5.07), being a patient who was retreated (adjusted OR 2.84), exposure to fluoroquinolones (adjusted OR 2.73), having COPD (adjusted OR 3.53), having COPD with known exposure to fluoroquinolones (adjusted OR 2.47), having MDR-TB (adjusted OR 1.67), and having poly-resistant TB (adjusted OR 2.34).
Conclusions:
These findings suggest that in high-risk populations continuous surveillance of fluoroquinolone resistance should be maintained. In addition, programs should be implemented for the management of patients with MDR-TB and more complicated TB, so as to minimize the further spread of fluoroquinolone resistance and extensively drug-resistant TB.
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