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. 2008 Nov;14(11):1700-6.
doi: 10.3201/eid1411.080729.

Multidrug- and extensively drug-resistant tuberculosis, Germany

Barbara Eker  1 , Johannes Ortmann, Giovanni B Migliori, Giovanni Sotgiu, Ralf Muetterlein, Rosella Centis, Harald Hoffmann, Detlef Kirsten, Tom Schaberg, Sabine Ruesch-Gerdes, Christoph Lange; German TBNET Group
Collaborators, Affiliations

Multidrug- and extensively drug-resistant tuberculosis, Germany

Barbara Eker et al. Emerg Infect Dis. 2008 Nov.

Abstract

We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004-2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean +/- SD 202 +/- 130 vs. 123 +/- 81 days; p = 0.015) and resistance to all first-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventy-four (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a definitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of second- and third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR- and XDR TB.

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Figures

Figure
Figure
Kaplan-Meier plot showing the time to sputum smear conversion according to treatment received (linezolid-containing regimen, n = 74, vs. linezolid-sparing regimen, n = 110) in Germany (log-rank test 0.0924). The proportion of case-patients reaching conversion is shown along the vertical axis.
See this image and copyright information in PMC

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