Multidrug-resistant tuberculosis in the United States, 2011-2016: patient characteristics and risk factors

• Published in: The international journal of tuberculosis and lung disease Vol. 24; no. 1; pp. 92 - 99
• Main Authors: Chen, M. P., Miramontes, R., Kammerer, J. S.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01-01-2020; International Union against Tuberculosis and Lung Disease (IUATLD)
• Subjects: Activation; Antitubercular Agents - therapeutic use; Disease transmission; Genotyping; Humans; Infections; Logistic Models; Mdr-Tb Contacts; Multidrug resistance; Multidrug resistant organisms; Mycobacterium tuberculosis; Odds Ratio; Previous Tb; Reactivation; Recent Transmission; Regression analysis; Regression models; Resistance factors; Risk analysis; Risk Factors; Surveillance; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis, Multidrug-Resistant - drug therapy; Tuberculosis, Multidrug-Resistant - epidemiology; United States - epidemiology; United States; United States > US
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.19.0173

OBJECTIVE: To determine risk factors for multidrug-resistant tuberculosis (MDR-TB) and describe MDR-TB according to three characteristics: previous TB disease, recent transmission of MDR-TB, and reactivation of latent MDR-TB infection.SETTING and DESIGN: We used 2011-2016
surveillance data from the US National Tuberculosis Surveillance System and National Tuberculosis Genotyping Service and used logistic regression models to estimate risk factors associated with MDR-TB.RESULTS: A total of 615/45 209 (1.4%) cases were confirmed as MDR-TB; 111/615
(18%) reported previous TB disease; 41/615 (6.7%) were attributed to recent MDR-TB transmission; and 449/615 (73%) to reactivation. Only 12/41 (29%) patients with TB attributed to recent transmission were known to be contacts of someone with MDR-TB. For non-US-born patients, the adjusted odds
ratios of having MDR-TB were 32.6 (95%CI 14.6-72.6) among those who were known to be contacts of someone with MDR-TB and 6.5 (95%CI 5.1-8.3) among those who had had previous TB disease.CONCLUSION: The majority of MDR-TB cases in the United States were associated with
previous TB disease or reactivation of latent MDR-TB infection; only a small proportion of MDR-TB cases were associated with recent transmission.