Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Jin-Bao Ma,1 Ling-Cheng Zeng,2 Fei Ren,1 Li-Yun Dang,1 Hui Luo,1 Yan-Qin Wu,1 Xin-Jun Yang,1 Rong Li,1 Han Yang,3 You Xu1 1Department of Drug-Resistance Tuberculosis, Xi’an Chest Hospital, Xi’an, People’s Republic of China; 2Xi’an Center for Disease Control and Prevention, Xi’an, People’s Republic of China; 3Department of Clinical Laboratory, Xi’an Chest Hospital, Xi’an, People’s Republic of ChinaCorrespondence: Fei Ren; You Xu, Department of Drug-resistance tuberculosis, Xi’an Chest Hospital, West Section of HangTian Avenue, Yanta District, Xi’an, People’s Republic of China, Email doc.renfei@163.com; xuyou7575@126.comBackground: Long-term regimens are widely used for multidrug-resistant tuberculosis (MDR-TB) in North-West China; however, risk factors associated with the treatment outcomes are not well known.Methods: This was a retrospective cohort study of MDR-TB patients treated with longer regimen in Xi’an from 2017 to 2019. Risk factors associated with the treatment outcome were analyzed using multiple logistic regression.Results: Of the 446 patients with MDR-TB included, 215 were cured, 84 completed treatment, 23 failed treatment, 108 were lost to follow-up, and 16 died. Unfavorable outcome risk factors were age > 40 years (OR = 3.25, 95% CI = 2.12– 4.98), male sex (OR = 2.53, 95% CI = 1.52– 4.22), and re-treated tuberculosis (OR = 1.70, 95% CI = 1.11– 2.61), whereas poor treatment outcome risk factors were age > 40 years (OR = 5.51, 95% CI = 2.52– 12.07), fluoroquinolones not used in the regimen (OR = 3.31, 95% CI = 1.45– 7.51), and smear-positive (OR = 4.0, 95% CI = 1.47– 10.8).Conclusion: In Xi’an, MDR-TB treatments with long-term regimens had low success rates, and age, sex, and tuberculosis treatment history were risk factors of MDR-TB treatment outcomes.Graphical Abstract: Keywords: tuberculosis, multidrug-resistant, treatment outcomes, risk factors, China