TY - JOUR AU - Kempker, Russell AU - Kipiani, Maia AU - Mirtskhulava, Veriko AU - Tukvadze, Nestani AU - Magee, Matthew AU - Blumberg, Henry T1 - Acquired Drug Resistance in Mycobacterium tuberculosis and Poor Outcomes among Patients with Multidrug-Resistant Tuberculosis T2 - Emerging Infectious Disease journal PY - 2015 VL - 21 IS - 6 SP - 992 SN - 1080-6059 AB - Rates and risk factors for acquired drug resistance and association with outcomes among patients with multidrug-resistant tuberculosis (MDR TB) are not well defined. In an MDR TB cohort from the country of Georgia, drug susceptibility testing for second-line drugs (SLDs) was performed at baseline and every third month. Acquired resistance was defined as any SLD whose status changed from susceptible at baseline to resistant at follow-up. Among 141 patients, acquired resistance in Mycobacterium tuberculosis was observed in 19 (14%); prevalence was 9.1% for ofloxacin and 9.8% for capreomycin or kanamycin. Baseline cavitary disease and resistance to >6 drugs were associated with acquired resistance. Patients with M. tuberculosis that had acquired resistance were at significantly increased risk for poor treatment outcome compared with patients without these isolates (89% vs. 36%; p<0.01). Acquired resistance occurs commonly among patients with MDR TB and impedes successful treatment outcomes. KW - tuberculosis and other mycobacteria KW - bacteria KW - multidrug resistance KW - acquired drug resistance KW - treatment outcomes KW - Mycobacterium tuberculosis KW - multidrug-resistant tuberculosis KW - MDR TB KW - extensively drug-resistant tuberculosis KW - XDR TB KW - antimicrobial resistance DO - 10.3201/eid2106.141873 UR - https://wwwnc.cdc.gov/eid/article/21/6/14-1873_article ER - End of Reference