Risk Factors for Drug-Resistant Tuberculosis

Marta Gomes, Ana Correia, Denisa Mendonça, Raquel Duarte

Chest Disease Centre Vila Nova de Gaia, Vila Nova de Gaia, Portugal; Pulmonology, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal; Reference Centre for Multidrug Resistant Tuberculosis, Northern Regional Health Administration, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
Institute of Public Health, University of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, Porto, Portugal.
Occupational Health, Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal.
Public Health Department, Northern Regional Health Administration, Porto, Portugal.

DOI: 10.4236/jtr.2014.23014                

Abstract

Objective: Drug resistance is considered one of the main threats for tuberculosis control. Our aim was to identify risk factors for drug resistance in tuberculosis patients in the Northern Portugal. Study Design and Methods: Retrospective case-control study. The medical records and drug susceptibility test data from TB patients diagnosed between 31 March 2009 and 1 April 2010 were examined. We enrolled 119 patients with any drug resistance to first line anti-TB drugs and 238 with drug-susceptible TB, matched by age group. Variables analyzed included: gender, country of origin, employment situation, site of disease, previous treatment, presence of diabetes mellitus, HIV infection, alcohol abuse, intravenous drug use, abuse of other drugs and smoking habits. Multivariate conditional logistic regression was used to identify independent predictors for drug-resistant TB. Results: Diabetes mellitus [adjusted odds ratio (OR): 3.54; 95% CI: 1.45 - 8.66], intravenous drug use (OR: 4.77; 95% CI: 1.24 - 18.32) and previous TB treatment (OR: 2.48; 95% CI: 1.12 - 5.49) were found to be risk factors for drug-resistant disease development. Conclusions: Diabetes mellitus, prior tuberculosis treatment, and intravenous drug use were risk factors for drug-resistant disease. The association between diabetes and drug-resistant TB should be further explored. Identifying clinical predictors of drug resistance can allow prompt identification of patients at risk for drug-resistant TB.

Keywords

Tuberculosis, Drug-Resistance, Risk, Diabetes, Portugal

Conflicts of Interest

The authors declare no conflicts of interest.

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