Adverse treatment outcomes in multidrug resistant tuberculosis are beyond the microbe drug interaction: Results of a multiple correspondence analysis

Abstract

Introduction: Multidrug-resistant tuberculosis treatment is effective in 50% of patients, due to several factors including the antibiotic susceptibility of the microorganism, adverse treatment reactions, social factors, and associated comorbidities. Objectives: Here we describe the demographics, clinical characteristics, and factors associated with treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) patients in Medellin, Colombia. Materials and methods: A retrospective analysis was performed of data from patients diagnosed with MDR-TB attending Hospital La Maria in Medellin-Colombia, who were treated between 2010-2015. Patients were categorized as having a successful (cured) or poor (failure, lost to follow-up, and death) treatment outcome. Associations between demographic, clinical factors, laboratory results, treatment outcomes, and follow-up information were evaluated by univariate, multivariate and multiple correspondence analyses (MCA). Results: 128 patients with MDR-TB, 77 (60%) had successful outcomes. Of those with poor outcomes, 26 were lost to follow-up, 15 died, and 10 were treatment failures. Irregular treatment, the presence of comorbidities, and positive cultures beyond >2 months of treatment were associated with poor outcomes compared to successful outcomes (p<0.05 for all). MCA grouped patients lost to follow-up with HIV and drug addiction, and patients with treatment failure with irregular treatment and chronic obstructive pulmonary disease. Conclusion: the recognition of factors affecting treatment outcomes is essential and was associated with treatment outcomes in this series of patients. Early identification of these factors should increase the rates of treatment success and contribute to MDR-TB control.