TY - JOUR T1 - Treatment outcome and factors associated with unfavourable treatment results in cases with multidrug-resistant tuberculosis in Bulgaria for the period 2009-2010 JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P3328 AU - Vladimir Milanov AU - Mariya Zamfirova AU - Tonka Varleva AU - Elizabeta Bachiyska AU - Antoniya Koleva Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P3328.abstract N2 - A retrospective study of all patients with MDR-TB in Bulgaria who started treatment for the period September 2009-March 2010 was performed. Aim: To make treatment outcome analysis and to determine the factors associated with unfavourable treatment results in cases with MDR-TB. Materials and methods: Medical records, recording and reporting forms for the MDR-TB cases included in treatment and TB registries of the NRL-TB were examined. Results: A total of 50 MDR-TB patients with mean age 45.8 years started treatment during the period. The male to female ratio was 2.3:1. Nineteen patients (38%) were new, and the other 31 cases were previously treated: 12 relapses (24%), after failure – 8 (16%), after default – 10 (20%). The median duration of recorded disease before treatment was 3.1 years (range, 0-13). None of all the patients tested for HIV had a positive result. Eight cases were found with XDR-TB during the treatment: 4 in 2010, and 4 – in 2011. Treatment was given for 18-24 months, including at least 12 months after culture conversion. Twenty four months after beginning of treatment, 24 patients (48%) were cured, 19 patients (38%) died, and one patient (2%) interrupted treatment. The cases with XDR-TB had higher mortality rate than the other MDR-TB cases (75% vs. 30.9%). Conclusion: This study shows high mortality rate in MDR-TB cases during two years after treatment initiation. XDR-TB is the strongest predictor of poor treatment outcomes. Previous TB treatment, weight loss and positive smears for acid-fast bacilli at the start of treatment are the other important factors associated with unfavourable treatment results. ER -