Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Figures & data

Figure 1 Flow chart study participants.

Abbreviation: MDR-TB, multidrug resistance tuberculosis.

Table 1 Characteristics of Patients with MDR-TB (n = 446)

Characteristics	Descriptive Analyses (n = 446), n (%)
Sex
Male	312 (70.0)
Female	134 (30.0)
Age (years)
≤20	39 (8.7)
20–40	227 (50.9)
>40	180 (40.4)
BMI (kg/m^2)
<18.5	127 (28.5)
≥18.5	319 (71.5)
Marriage
Married	292 (65.5)
Single	139 (31.2)
Divorced	13 (2.9)
Widowed	2 (0.4)
Address
Xi’an	189 (42.4)
Other regions	257 (57.6)
Treatment history
Initial treatment tuberculosis	236 (52.9)
Retreat tuberculosis	210 (47.1)
Diabetes mellitus	70 (15.7)
Sputum/BALF smear
0	182 (40.8)
1+	106 (23.8)
2+	53 (11.9)
3+	49 (11.0)
4+	56 (12.5)
Drug sensitivity test
Fluoroquinolones
Not done	24 (5.4)
Sensitive	320 (71.7)
Resistant	102 (22.9)
Second-line injections
Not done	24 (5.4)
Sensitive	407 (91.3)
Resistant	15 (3.3)
Cavity	161 (36.1)
Drugs used in the regimen
Fluoroquinolones	373 (83.6)
Second-line injections	431 (96.6)
Linezolid	113 (25.3)
Clofazimine	36 (8.1)
Cycloserine	332 (74.4)
Ethambutol	181 (40.6)
Pyrazinamid	439 (98.4)
Prothionamide	406 (91.0)
P-aminosalicylate	30 (6.7)

Table 2 Univariate and Multiple Analyses of Factors Associated with Unfavorable Outcome

Characteristics	Unfavorable Outcome (Failure, Died, Lost to Follow-Up) N = 446
	n (%)	OR (95%Cl)	P value	Adj OR (95%Cl)	P value
Sex
Female	25 (18.7)	Reference	<0.001	Reference	<0.001
Male	122 (39.1)	2.80 (1.71–4.57)		2.53 (1.52–4.22)
Age (years)
≤40	57 (21.4)	Reference	<0.001	Reference	<0.001
>40	90 (50.0)	3.67 (2.42–5.55)		3.25 (2.12–4.98)
BMI (Kg/m^2)
≤18.5	48 (37.8)	Reference	0.170	–
>18.5	99 (31.0)	0.74 (0.48–1.14)		–
Marriage
Married	107 (36.6)	Reference	0.023	–
Unmarried	40 (26.0)	0.61 (0.39–0.93)		–
Address
Xi’an	65 (34.4)	Reference	0.581	–
Other regions	82 (31.9)	0.89 (0.60–1.33)		–
Treatment history
Initial treatment tuberculosis	60 (25.4)	Reference	<0.001	Reference	0.014
Retreat tuberculosis	87 (41.4)	2.08 (1.39–3.10)		1.70 (1.11–2.61)
Diabetes
No	112 (29.8)	Reference	0.001	–
Yes	35 (50.0)	2.36 (1.40–3.96)		–
Sputum or BALF smear
Negative	45 (24.8)	Reference	0.002	–
Positive	102 (38.6)	1.92 (1.26–2.91)		–
Drug sensitivity test
Fluoroquinolones
Sensitive	107 (31.8)	Reference	0.382	–
Resistant	40 (36.4)	1.22 (0.78–1.92)		–
Second-line injections
Sensitive	141 (32.8)	Reference	0.694	–
Resistant	6 (37.5)	1.23 (0.44–3.45)		–
Cavity
Yes	57 (35.4)	Reference	0.409	–
No	90 (31.6)	0.84 (0.56–1.27)		–
Drugs used in the regimen
Fluoroquinolones
Yes	118 (31.6)	Reference	0.179	–
NO	29 (39.7)	1.42 (0.85–2.39)		–
Second-line injections
Yes	141 (32.7)	Reference	0.555	–
NO	6 (40.0)	1.37 (0.48–3.93)		–
Linezolid
Yes	39 (34.5)	Reference	0.684	–
NO	108 (32.4)	0.91 (0.58–1.43)		–
Clofazimine
Yes	14 (38.9)	Reference	0.430	–
NO	133 (32.4)	0.76 (0.37–1.52)		–
Cycloserine
Yes	104 (31.3)	Reference	0.210	–
NO	43 (37.7)	1.33 (0.85–2.07)		–
Ethambutol
Yes	57 (31.5)	Reference	0.586	–
NO	90 (34.0)	1.12 (0.75–1.68)		–
Pyrazinamide
Yes	145 (33.0)	Reference	0.803	–
NO	2 (28.6)	0.81 (0.16–4.23)		–
Prothionamid
Yes	135 (33.3)	Reference	0.676	–
NO	12 (30.0)	0.86 (0.42–1.75)		–
P-aminosalicylate
Yes	14 (46.7)	Reference	0.098	–
NO	133 (32.0)	0.54 (0.26–1.13)		–

Table 3 Univariate and Multiple Analyses of Factors Associated with Poor Treatment Outcome

Characteristics	Poor Treatment Outcome (Failure, Died) N = 338
	n (%)	OR (95%Cl)	P value	Adj OR (95%Cl)	P value
Sex
Female	8 (6.8)	Reference	0.049	–
Male	31 (14.0)	2.22 (0.99–5.01)		–
Age (years)
≤40	11 (5.0)	Reference	<0.001	Reference	<0.001
>40	28 (23.7)	5.91 (2.82–12.39)		5.51 (2.52–12.07)
BMI (Kg/m^2)
≤18.5	14 (15.1)	Reference	0.213	–
>18.5	25 (10.2)	0.64 (0.32–1.30)		–
Marriage
Married	33 (15.1)	Reference	0.005	–
Unmarried	6 (5.0)	0.30 (0.12–0.73)		–
Address
Xi’an	17 (12.1)	Reference	0.801	–
Other regions	22 (11.2)	0.92 (0.47–1.80)		–
Treatment history
Initial treatment tuberculosis	17 (8.8)	Reference	0.070	–
Retreat tuberculosis	22 (15.2)	1.85 (0.94–3.63)		–
Diabetes
No	7 (16.7)	Reference	0.266	–
Yes	32 (10.8)	1.65 (0.68–4.02)		–
Sputum or BALF smear
Negative	5 (3.5)	Reference	<0.001	Reference	0.007
Positive	34 (17.3)	5.75 (2.19–15.11)		4.0 (1.47–10.8)
Drug sensitivity test
Fluoroquinolones
Sensitive	27 (10.5)	Reference	0.313	–
Resistant	12 (14.6)	1.45 (0.70–3.02)		–
Second-line injections
Sensitive	38 (11.6)	Reference	0.796	–
Resistant	1 (9.1)	0.76 (0.10–6.11)		–
Cavity
Yes	15 (12.6)	Reference	0.651	–
No	24 (11.0)	0.85 (0.43–1.70)		–
Drugs used in the regimen
Fluoroquinolones
Yes	26 (9.3)	Reference	0.003	Reference	0.004
NO	13 (22.8)	2.90 (1.38–6.07)		3.31 (1.45–7.51)
Second-line injections
Yes	37 (11.3)	Reference	0.483	–
NO	2 (18.2)	1.74 (0.36–8.37)		–
Linezolid
Yes	15 (16.9)	Reference	0.067	-
NO	24 (9.6)	0.53 (0.26–1.06)		-
Clofazimine
Yes	8 (26.7)	Reference	0.007	–
NO	31 (10.1)	0.31 (0.13–0.75)		–
Cycloserine
Yes	27 (10.6)	Reference	0.338	–
NO	12 (14.5)	1.43 (0.69–2.96)		–
Ethambutol
Yes	17 (12.1)	Reference	0.801	–
NO	22 (11.2)	0.92 (0.47–1.80)		–
Pyrazinamide
Yes	39 (11.7)	Reference	0.416	–
NO	0 (0)	0.88 (0.85–0.92)		–
Prothionamid
Yes	31 (10.3)	Reference	0.034	–
NO	8 (22.2)	2.50 (1.05–5.96)		–
P-aminosalicylate
Yes	5 (23.8)	Reference	0.069	–
NO	34 (10.7)	0.38 (0.13–1.12)		–