Evidence map›Paper›PMID 38544531›Full record

ArticleIndian journal of orthopaedics2024

Treatment Outcome of Drug-Resistant Skeletal Tuberculosis: A Retrospective Analysis.

Himanshu Gupta, Rajesh Arora, Manish Chadha, I K Dhammi, Anil K Jain

Abstract read
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Article in Indian journal of orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Himanshu GuptaDepartment of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.
Rajesh AroraDepartment of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.
Manish ChadhaDepartment of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.
I K DhammiDepartment of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.
Anil K JainDepartment of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Management outcomes of drug-resistant (DR) osteoarticular tuberculosis (OATB) is dismal as in pre-ATT era (1905). The studies documenting treatment outcome of DR-OATB are scarce; hence, present retrospective analysis was conducted to evaluate outcome of consecutive cases of DR-OATB. Methods: 45 consecutive patients of suspected DR-OATB were treated from 2010 onwards. Tissue samples were submitted for AFB smear, cytology/histology, liquid culture, CBNAAT/LPA besides gram's staining and aerobic/anaerobic culture. Patients were treated by individualized second-line ATT till documenting healed status by contrast MRI/PET. The changes in neurological deficit, deformities, and drug-induced adverse events were documented. Results: 37/45 patients, 15 males and 22 females, mean age 26.89 years were followed. DR was suspected observing poor clinico-radiological response/appearance of fresh lesions on ATT. All showed no growth on aerobic/anaerobic pyogenic culture. 29 (78%) had microbiologically proven drug resistance and 8 (22%) were labeled as clinical drug resistance (CDR). 18/29 had multi-drug resistance. Mean prior ATT intake was 12.03 months 15 (40%) underwent surgical decompression. Mean duration of second-line ATT was 22.5 months (9-36 months). All patients achieved healed status with 8 (21%) developed side effects, most commonly hepatotoxicity, ototoxicity, and psychiatric disturbances. Average follow-up after completion of ATT was 40.5 months. Conclusion: We report a large series where patients of DR-OATB were suspected on clinical criteria, investigated by DST, and treated. Patients with proven drug resistance were treated by individualized second-line ATT. CDR cases were treated by MDR protocol. Genotypic DST (CBNAAT/LPA) improved demonstration of DR. We demonstrated healed status on MRI/PET with no recurrence at minimum 2-year follow-up. Graphical Abstract:

Indexed as

Drug resistanceGenotypic GSTMDR-TBPhenotypic DSTSecond-line ATTSpinal tuberculosis

Identifiers

PMID38544531
PMCPMC10963675

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