In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 6 ( 2022-6-24), p. e0270201-
Abstract:
Little is known about the impact of drug-resistance on clinical outcomes among patients with tuberculosis meningitis (TBM). Methods A retrospective cohort study among patients treated for TBM in Tbilisi, Georgia. We performed medical chart abstraction to collect patient data. Long-term vital status was assessed using the Georgia National Death Registry. We utilized a Cox proportional-hazards model to evaluate the association of drug-resistance and mortality. Results Among 343 TBM suspects, 237 had a presentation consistent with TBM. Drug resistance was suspected (n = 5) or confirmed (n = 31) in 36 patients including 30 with multidrug- or rifampin-resistance and 6 with isoniazid-resistance. Thirty-four patients had HIV. The median follow-up time was 1331 days (IQR, 852–1767). Overall, 73 of 237 (30%) people died with 50 deaths occurring during and 23 after treatment. The proportion of death was higher among patients with drug-resistant vs. drug-susceptible disease (67% vs. 24%, p 〈 0.001) and with HIV versus no HIV (59% vs 27%, p 〈 0.001). Mortality was significantly higher in patients with drug-resistant TBM after 90 days of treatment (aHR = 7.2, CI 95% [3.6–14.3], p 〈 0.001). Conclusions Mortality was high among patients with drug-resistant TBM with many deaths occurring post treatment. More effective treatment options are urgently needed for drug-resistant TBM.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0270201
DOI:
10.1371/journal.pone.0270201.g001
DOI:
10.1371/journal.pone.0270201.g002
DOI:
10.1371/journal.pone.0270201.t001
DOI:
10.1371/journal.pone.0270201.t002
DOI:
10.1371/journal.pone.0270201.t003
DOI:
10.1371/journal.pone.0270201.s001
DOI:
10.1371/journal.pone.0270201.s002
DOI:
10.1371/journal.pone.0270201.s003
DOI:
10.1371/journal.pone.0270201.s004
DOI:
10.1371/journal.pone.0270201.r001
DOI:
10.1371/journal.pone.0270201.r002
DOI:
10.1371/journal.pone.0270201.r003
DOI:
10.1371/journal.pone.0270201.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
Permalink