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Treatment outcomes among multidrug-resistant tuberculosis (MDR-TB) cases at a referral hospital of infectious diseases in Italy

Gina Gualano, Rocco Urso, Rosati Silvia, Tonnarini Roberto, Biagioli Daniele, Matteucci Giuseppe, Ghirga Piero, Murachelli Silvia, Di Caro Antonino, Biava Gianluigi, Goletti Delia, Girardi Enrico, Ippolito Giuseppe, Lauria Francesco Nicola, Palmieri Fabrizio
European Respiratory Journal 2016 48: PA2688; DOI: 10.1183/13993003.congress-2016.PA2688
Gina Gualano
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Rocco Urso
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Rosati Silvia
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Tonnarini Roberto
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Biagioli Daniele
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Matteucci Giuseppe
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Ghirga Piero
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Murachelli Silvia
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Di Caro Antonino
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Biava Gianluigi
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Goletti Delia
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Girardi Enrico
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Ippolito Giuseppe
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Lauria Francesco Nicola
2National Institute for Infectious Diseases 'L. Spallanzani', National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Palmieri Fabrizio
1Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
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Abstract

Background: MDR-TB is emerging as a major challenge for tuberculosis control programs.In Italy the proportion of MDR-TB reported during 2013 was 3.3%; unfortunately, treatment outcomes in MDR-TB patients are poorly documented.

Aim: To evaluate the outcomes of MDR-TB patients treated at the National Institute of Infectious Disease (INMI), a referral hospital for Infectious Diseases in Italy.

Methods: 74 MDR-TB patients diagnosed between 2008 and 2015 were consecutively enrolled in an observational retrospective cohort study. All patients were treated according WHO guidelines.

Results: The patients (median age 35.8 yr) were mainly male (63.5%) and foreign born (87.2%). Among 74 patients, 2 were extensively drug-resistant (XDR) cases, 2 patients were HIV-coinfected,and 45 (61.0%) were newly diagnosed. Fifty-eight (78.4%) cases were pulmonary sputum smear-positive. 51% of patients were transferred in from units of other regions of central and southern Italy. Among 57 patients who completed treatment in the study period, 68.4 % achieved treatment success, 22.8% were lost to follow up, 3% were transferred out and 1.8% died.

Conclusion: Monitoring the treatment outcome of MDR-TB is essential to evaluate the effectiveness of interventions and to identify potential barriers for TB control. In our cohort MDR-TB is mainly related to the immigration of patients from countries with a high TB prevalence with a high proportion of new cases. Data show that, in a referral center for the treatment of MDR-TB, success rates close to the target defined by WHO can be achieved, even if actions are required to reduce the high proportion of patients lost to follow-up.

  • Tuberculosis - management
  • MDR-TB
  • Tuberculosis - diagnosis
  • Copyright ©the authors 2016
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Treatment outcomes among multidrug-resistant tuberculosis (MDR-TB) cases at a referral hospital of infectious diseases in Italy
Gina Gualano, Rocco Urso, Rosati Silvia, Tonnarini Roberto, Biagioli Daniele, Matteucci Giuseppe, Ghirga Piero, Murachelli Silvia, Di Caro Antonino, Biava Gianluigi, Goletti Delia, Girardi Enrico, Ippolito Giuseppe, Lauria Francesco Nicola, Palmieri Fabrizio
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2688; DOI: 10.1183/13993003.congress-2016.PA2688

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Treatment outcomes among multidrug-resistant tuberculosis (MDR-TB) cases at a referral hospital of infectious diseases in Italy
Gina Gualano, Rocco Urso, Rosati Silvia, Tonnarini Roberto, Biagioli Daniele, Matteucci Giuseppe, Ghirga Piero, Murachelli Silvia, Di Caro Antonino, Biava Gianluigi, Goletti Delia, Girardi Enrico, Ippolito Giuseppe, Lauria Francesco Nicola, Palmieri Fabrizio
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2688; DOI: 10.1183/13993003.congress-2016.PA2688
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