Risk factors for Candida colonization and Co-colonization with multi-drug resistant organisms at admission

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

Download Full-text

Multi-drug resistant Acinetobacter baumannii infection, risk factors for mortality

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.09.428 ◽

2020 ◽

Vol 101 ◽

pp. 158

Author(s):

D. Alrahmany ◽

L. Pontiggia ◽

I. Ghazi

Keyword(s):

Risk Factors ◽

Acinetobacter Baumannii ◽

Infection Risk ◽

Drug Resistant ◽

Infection Risk Factors

Download Full-text

Urinary Tract Infections Caused by Multi-Drug Resistant Proteus mirabilis: Risk Factors and Clinical Outcomes

Infection ◽

10.1007/s15010-009-8460-5 ◽

2009 ◽

Vol 38 (1) ◽

pp. 41-46 ◽

Cited By ~ 38

Author(s):

K. Cohen-Nahum ◽

L. Saidel-Odes ◽

K. Riesenberg ◽

F. Schlaeffer ◽

A. Borer

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Clinical Outcomes ◽

Urinary Tract Infections ◽

Proteus Mirabilis ◽

Drug Resistant ◽

Tract Infections

Download Full-text

Response to Cassiana G. Prates' submission: advances in the way of dealing with antibiotic exposure in studies assessing risk factors for drug-resistant pathogenes

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2009.01.014 ◽

2009 ◽

Vol 64 (1) ◽

pp. 103

Author(s):

Jann-Tay Wang ◽

Shan-Chwen Chang

Keyword(s):

Risk Factors ◽

Drug Resistant ◽

Antibiotic Exposure ◽

The Way

Download Full-text

Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004–2019

BMJ Open ◽

10.1136/bmjopen-2020-044349 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044349

Author(s):

Ning-ning Tao ◽

Yi-fan Li ◽

Wan-mei Song ◽

Jin-yue Liu ◽

Qian-yun Zhang ◽

...

Keyword(s):

Risk Factors ◽

Drug Resistance ◽

Retrospective Study ◽

Pulmonary Tuberculosis ◽

Logistic Models ◽

Smoking History ◽

Categorical Variables ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis

ObjectiveThis study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).DesignA retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.ResultsA total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).ConclusionSmoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.

Download Full-text