Volume 24, Number 3—March 2018
Research
Acquired Resistance to Antituberculosis Drugs in England, Wales, and Northern Ireland, 2000–2015
Miranda G. Loutet
, Jennifer A. Davidson, Tim Brown, Martin Dedicoat, H. Lucy Thomas, and Maeve K. Lalor
, Jennifer A. Davidson, Tim Brown, Martin Dedicoat, H. Lucy Thomas, and Maeve K. Lalor
Table 7
Univariable and multivariable logistic regression model 2 for acquired resistance to anti-TB drugs in England, Wales, and Northern Ireland, 2010–2015*
| Characteristic | No acquired drug resistance, no. (%) | Acquired drug resistance, no. (%) | Univariable analysis |
Multivariable analysis |
|||
|---|---|---|---|---|---|---|---|
| OR (95% CI) | p value | aOR (95% CI) | p value | ||||
| Age, y | |||||||
| 0–14 | 467 (1.8 ) | 0 | NA | NA | NA | NA | |
| 15–44 | 17,119 (64.6) | 48 (64.9) | 1.0 | NA | 1.0 | NA | |
| 45–64 | 5,429 (20.5) | 23 (31.1) | 1.5 (0.9–2.5) | 0.1 | 1.9 (1.0–3 6) | 0.04 | |
| >65 |
3,503 (13.2) |
3 (4.1) |
0.3 (0.1–0.9) |
0.05 |
0.6 (0.2–2.2) |
0.5 |
|
| Sex | |||||||
| F | 10,664 (40.3) | 24 (32.4) | 1.0 | NA | 1.0 | NA | |
| M |
15,820 (59.7) |
50 (67.6) |
1.4 (0.9–2.3) |
0.2 |
1.3 (0.7–2.3) |
0.4 |
|
| Site of disease | |||||||
| Extrapulmonary only | 10,069 (38.0) | 10 (13.5) | 1.0 NA | NA | 1.0 | NA | |
| Pulmonary with or
without extrapulmonary |
16,443 (62.0) |
64 (86.5) |
3.9 (2.0–7.6) |
<0.001 |
2.7 (1.2–6.0) |
0.01 |
|
| Initial drug resistance | |||||||
| Drug sensitive | 24,659 (93.0) | 25 (33.8) | 1.0 | NA | 1.0 | NA | |
| Isoniazid resistance without MDR | 1,446 (5.4) | 13 (17.6) | 8.9 (4.5–17.4) | <0.001 | 6.5 (2.9–14.4) | <0.001 | |
| Rifampin resistance without MDR | 50 (0.2) | 1 (1.4) | 19.7 (2.6–148.4) | 0.004 | 14.7 (1.8–123.0) | 0.01 | |
| MDR |
363 (1.4) |
35 (47.3) |
95.1 (56.3–160.5) |
<0.001 |
77.3 (39.1–152.8) |
<0.001 |
|
| Country of birth | |||||||
| United Kingdom | 6,239 (24.6) | 21 (29.2) | 1.0 | NA | 1.0 | NA | |
| China | 183 (0.7) | 3 (4.2) | 4.9 (1.4–16.5) | 0.01 | 2.1 (0.5–9.5) | 0.3 | |
| India | 5,470 (21.6) | 5 (6.9) | 0.3 (0.1–0.7) | 0.01 | 0.3 (0.1–0.8) | 0.02 | |
| Lithuania | 181 (0.7) | 8 (11.1) | 13.3 (5.7–30.0) | <0.001 | 0.6 (0.2–1.8) | 0.3 | |
| Pakistan | 3,270 (12.9) | 5 (6.9) | 0.5 (0.2–1.2) | 0.1 | 0.7 (0.2–2.5) | 0.6 | |
| Somalia | 1,191 (4.7) | 3 (4.2) | 0.8 (0.2–2.5) | 0.7 | 0.6 (0.1–2.7) | 0.5 | |
| South Africa | 174 (0.7) | 1 (1.4) | 1.7 (0.2–12.8) | 0.6 | 1.3 (0.1–11.7) | 0.8 | |
| Nigeria | 579 (2.3) | 2 (2.8) | 1.0 (0.2–4.4) | 0.9 | 0.9 (0.1–6.9) | 0.9 | |
| Other |
8,080 (31.8) |
24 (33.3) |
0.9 (0.5–1.6) |
0.7 |
0.7 (0.3–1.4) |
0.3 |
|
| Previous TB episode | |||||||
| No | 23,799 (94.5) | 57 (80.3) | 1.0 | NA | 1.0 | NA | |
| Yes |
1,391 (5.5) |
14 (19.7) |
4.2 (2.3–7.6) |
<0.001 |
1.7 (0.8–3.4) |
0.2 |
|
| Social risk factors | |||||||
| 0 | 20,163 (88.4) | 47 (72.3) | 1.0 | NA | 1.0 | NA | |
| >1 |
2,632 (11.6) |
18 (27.7) |
2.9 (1.7–5.1) |
<0.001 |
1.0 (0.5–2.0) |
1.0 |
|
| Organism lineage | |||||||
| Euro-American | 8,631 (39.3) | 18 (26.5) | 1.0 | NA | 1.0 | NA | |
| Central Asian | 6,013 (27.4) | 9 (13.2) | 0.7 (0.3–1.6) | 0.4 | 1.0 (0.4–2.8) | 0.9 | |
| East-African-Indian | 3,098 (14.1) | 6 (8.8) | 0.9 (0.4–2.3) | 0.9 | 1.3 (0.5–3.9) | 0.6 | |
| Beijing | 1,230 (5.6) | 23 (33.8) | 9.0 (4.8–16.7) | <0.001 | 3.4 (1.6–7.4) | 0.002 | |
| Mycobacterium africanum | 192 (0.9) | 0 | NA | NA | NA | NA | |
| M.bovis | 124 (0.6) | 2 (2.9) | 7.7 (1.8 |
0.01 | 10.3 (2.1–49.8) | 0.004 | |
| Multiple | 599 (2.7) | 2 (2.9) | 1.6 (0.4–7.0) | 0.5 | 1.4 (0.3–6.7) | 0.7 | |
| None | 2,076 (9.4) | 8 (11.8) | 1.8 (0.8–4.3) | 0.1 | 1.9 (0.8–4.9) | 0.2 | |
*aOR, adjusted OR; MDR, multidrug-resistant; NA, not applicable; OR, odds ratio; TB, tuberculosis.
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