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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis

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High risk and rapid appearance of multidrug resistance during tuberculosis treatment in Moldova

Helen E Jenkins1, Valeriu Crudu, Viorel Soltan

  • 1Boston, MA.

The European Respiratory Journal
|February 22, 2014
PubMed

Insights

Multidrug-resistant tuberculosis (MDR-TB) can develop during treatment, with 7.2–9.2% of cases diagnosed after initial non-MDR-TB confirmation. Rapid MDR-TB diagnosis is crucial, as half occur within 3 months.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Multidrug-resistant tuberculosis (MDR-TB) poses a significant global health challenge, particularly in regions like the former Soviet Union.
  • MDR-TB can emerge during the course of standard tuberculosis (TB) treatment, complicating patient management and increasing transmission risk.

Purpose of the Study:

  • To determine the prevalence and timing of MDR-TB diagnosis among patients initially treated for non-MDR-TB in Moldova.
  • To identify factors associated with the development of MDR-TB during TB treatment.

Main Methods:

  • Analysis of a large cohort (3,754 patients) from the Moldovan TB surveillance database (2007-2010).
  • Inclusion of patients with confirmed baseline non-MDR-TB who underwent serial sputum drug-susceptibility testing during treatment.
  • Application of a failure-time model to assess factors linked to MDR-TB diagnosis.

Main Results:

  • Between 7.2% and 9.2% of initially non-MDR-TB cases were diagnosed with MDR-TB during treatment.
  • Half of these MDR-TB diagnoses occurred within three months of the initial TB diagnosis.
  • Factors associated with increased MDR-TB risk during treatment included baseline resistance to first-line drugs, prior incarceration, and HIV co-infection.

Conclusions:

  • MDR-TB can develop rapidly during TB treatment, highlighting the need for vigilant monitoring.
  • Interventions should focus on early treatment management, including ambulatory care to prevent nosocomial spread.
  • Universal access to rapid diagnostics is essential to prevent the acquisition and transmission of drug-resistant TB strains.

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