Evidence map›Paper›PMID 40140735›Full record

ArticleBMC infectious diseases2025

Risk factors for poor outcomes in patients with drug-resistant tuberculosis: a 6-year multicenter prospective study in Zhejiang, China.

Xuewen Feng, Li Hong, Zhongkang Ji, Cheng Ding, Yanwan Shangguan, Wanru Guo, Songhua Chen, Zebao He, Ying Zhang, Bing Ruan and 1 more

Abstract readMulticenter Study
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Xuewen Feng *State Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Li Hong *Department of Infectious Diseases, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Zhongkang JiState Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Cheng DingState Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Yanwan ShangguanInfection Control Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Wanru GuoState Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
Songhua ChenInstitute of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Zebao HeDepartment of Infectious Diseases, Taizhou Enze Medical Center (Group), Enze Hospital, Taizhou, China.
Ying Zhang *State Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China. yzhang207@zju.edu.cn.
Bing Ruan *State Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China. ruanbing@zju.edu.cn.
Kaijin Xu *State Key Laboratory for Diagnosisandaqtreatment of Infectious Diseasescollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China. zdyxyxkj@zju.edu.cn.

Funding

Fundamental Research Funds for the Central Universities 2022ZFJH003Jinhua Science and Technology Bureau 2019-4-108Science and Technology Plan Project of Taizhou XM2020537
6 · The paper itself

Abstract

backgroundAt present, the disease burden of drug-resistant tuberculosis (DR-TB) is still heavy in the world. In this study, we aimed to evaluate the success rate of DR-TB patients after standardized treatment and to analyze the risk factors for poor outcomes in Zhejiang, China.

methodsFrom 2017 to 2021, all culture-confirmed tuberculosis (TB) patients were prospectively enrolled from three designated TB hospitals in Zhejiang, China. Demographic surveys were conducted in all patients, and drug susceptibility of TB strains was tested by fluorescent polymerase chain reaction probe melting curve analysis (MeltPro). DR-TB patients were treated with WHO recommended standardized treatment according to the type of drug resistance, and the outcomes were thoroughly monitored and tracked until June 2023. Binary logistic regression model was used to analyze the related risk factors of poor outcomes in patients with DR-TB. The patients' socio-demographic information, comorbidities, fever, antibiotic use, laboratory test results, lung imaging characteristics and drug resistance characteristics were included in the analysis. A simple TB severity score was developed according to the WHO definition and applied to the analysis.

resultsAmong 1013 patients with confirmed TB, 779 were sensitive to all of the tested drugs (rifampicin, isoniazid, ethambutol, streptomycin and fluoroquinolones), and 234 were resistant to at least one tested drug. Among the 234 DR-TB patients in the study, 50 patients had poor outcomes (23 cases of failure, 13 cases of death, and 14 patients lost to follow-up), 158 patients were successfully treated (125 cases were cured and 33 cases completed treatment), and 26 were referred to other provinces. The overall treatment success rate was 76.0% (158/208). Multivariate analysis showed that age (AOR 1.03; 95%CI 1.01-1.05), previous TB treatment history (AOR 5.03; 95%CI 1.33-18.99), higher TB severity score (AOR 1.48; 95%CI 1.09-2.03), MDR/RR-TB (AOR 8.34; 95%CI 2.99-23.24) and pre-XDR-TB (AOR 9.50; 95%CI 2.24-40.26) were independent risk factors for poor outcomes in DR-TB patients.

conclusionsThe treatment success rate of DR-TB patients in this study reached that of the WHO standard treatment (75%). Physicians should be alert to the possibility of poor outcomes in DR-TB patients with old age, previous TB treatment history, higher TB severity score, MDR/RR-TB or pre-XDR-TB.

Indexed as

Antitubercular AgentsTuberculosis, Multidrug-ResistantAdolescentAdultAgedChinaFemaleHumansMaleMicrobial Sensitivity TestsMiddle AgedMycobacterium tuberculosisProspective StudiesRisk FactorsTreatment OutcomeYoung AdultAntitubercular AgentsDrug-resistant tuberculosisDrug-susceptibility testOutcomesProspective multicenter studyRisk factorsStandardized treatmentTuberculosis severity score

Identifiers

PMID40140735
PMCPMC11948875

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