TY - JOUR AU - Smith, Sarah AU - Ershova, Julia AU - Vlasova, Natalia AU - Nikishova, Elena AU - Tarasova, Irina AU - Eliseev, Platon AU - Maryandyshev, Andrey AU - Shemyakin, Igor AU - Kurbatova, Ekaterina AU - Cegielski, J. Peter T1 - Risk Factors for Acquisition of Drug Resistance during Multidrug-Resistant Tuberculosis Treatment, Arkhangelsk Oblast, Russia, 2005–2010 T2 - Emerging Infectious Disease journal PY - 2015 VL - 21 IS - 6 SP - 1002 SN - 1080-6059 AB - Acquired resistance to antituberculosis drugs decreases effective treatment options and the likelihood of treatment success. We identified risk factors for acquisition of drug resistance during treatment for multidrug-resistant tuberculosis (MDR TB) and evaluated the effect on treatment outcomes. Data were collected prospectively from adults from Arkhangelsk Oblast, Russia, who had pulmonary MDR TB during 2005–2008. Acquisition of resistance to capreomycin and of extensively drug-resistant TB were more likely among patients who received <3 effective drugs than among patients who received >3 effective drugs (9.4% vs. 0% and 8.6% vs. 0.8%, respectively). Poor outcomes were more likely among patients with acquired capreomycin resistance (100% vs. 25.9%), acquired ofloxacin resistance (83.6% vs. 22.7%), or acquired extensive drug resistance (100% vs. 24.4%). To prevent acquired drug resistance and poor outcomes, baseline susceptibility to first- and second-line drugs should be determined quickly, and treatment should be adjusted to contain >3 effective drugs. KW - tuberculosis and other mycobacteria KW - antimicrobial drug resistance KW - Russia KW - acquired drug resistance KW - risk factors KW - antimicrobial resistance KW - bacteria DO - 10.3201/eid2106.141907 UR - https://wwwnc.cdc.gov/eid/article/21/6/14-1907_article ER - End of Reference