Comparison of bacteriological conversion and treatment outcomes among MDR-TB patients with and without diabetes in Mexico: Preliminary data

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• 作者：M. Muñ ; oz-Torrico^a ; J. Caminero Luna^b ; G.B. Migliori^c ; ^{giovannibattista.migliori@fsm.it} ; L. D&rsquo ; Ambrosio^c ; ^d ; J.L. Carrillo-Alduenda^e ; H. Villareal-Velarde^a ; A. Torres-Cruz^a ; H. Flores-Ergara^a ; D. Martí ; nez-Mendoza^a ; C. Garcí ; a-Sancho^f ; R. Centis^c ; M.Á ; . Salazar-Lezama^a ; R. Pé ; rez-Padilla^e
• 关键词：Diabetes mellitus ; Delay ; Sputum and culture conversion ; MDR-TB ; High treatment adherence
• 刊名：Revista Portuguesa de Pneumologia (English Edition)
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：23
• 期：1
• 页码：27-30
• 全文大小：431 K
• 卷排序：23

文摘

Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). However, it is not known to what extent DM affects the outcome in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) treated with second-line anti-TB drugs.The objective of this study was to compare the microbiological evolution (sputum smear and culture conversion) and final outcomes of MDR/XDR-TB patients with and without DM, managed at the national TB reference centre in Mexico City.ResultsNinety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81.1%), 11 with pre-XDR-TB (e.g. MDR-TB with additional resistance to one injectable drug or a fluoroquinolone, 12.2%) and 6 (6.7%) with XDR-TB. Out of these, 49 (54.4%) had DM and 42 (86%) were undergoing insulin treatment.No statistically significant differences were found in treatment outcomes comparing DM vs. non-DM MDR-TB cases: 18/32 (56.3%) of DM cases and 19/24 (79.2%) non DM patients achieved treatment success (p = 0.07). The time to sputum smear and culture conversion was longer (although not statistically) in patients without DM, as follows: the mean (±SD) time to sputum smear conversion was 53.9 (±31.4) days in DM patients and 65.2 (±34.8) days in non-DM ones (p = 0.15), while the time to culture conversion was 66.2 (±27.6) days for DM and 81.4 (±37.7) days for non-DM MDR-TB cases (p = 0.06).ConclusionsThe study results support the Mexican National TB programme to strengthen its collaboration with the DM programme, as an entry point for TB (and latent TB infection) screening and management.