Page 66 - Livre électronique du Congrès National de Pneumologie 2018

C013 IMPACT OF DRUG RESISTANCE PATTERNS IN PATIENTS WITH MULTI-DRUG

RESISTANT TUBERCULOSIS
Ben Mansour A., Daghfous H., Ben saad S., Snen H., Zoghlami M., Tritar F.

SERVICE DE PNEUMOLOGIE PAVILLON C HOPITAL A. MAMI ARIANA

Introduction:

Multidrug-resistant TB (MDR-TB) is a major public health problem in Africa and Asia and it is often acquired. Clinical,
therapeutic and evolution characteristics of primary or secondary resistance are unknown.

Aim :
Analyse patients' demographic data, clinical and radiological findings, bacteriological smear and culture status after
treatment and outcome according to the resistance profile.

Methods :
Retrospective study (2001- 2017) including patients with MDR-TB confirmed with drug sensitive test and treated
according to WHO recommendations in the referral center for care of MDR-TB in Tunisia (Pneumology “C”
department).
Results :

Eighty-five MDR-TB cases were enrolled (mean age 36.5 years, 63 men and 22 women). Secondary resistance (G1)
and primary resistance (G2) were identified respectively in 63 cases (G1 : mean age: 36.7, 49H 14F) and 22 cases
(G2 : mean age 35.5, 14H 8F) = G2. Comparing dermographic data and socio-economic conditions, there was no
significant difference in the 2 groups. For comorbidities, diabetes was present in both groups (30.1% G1 vs 22.7%).

Patients smokers were significatively frequent in G2 (22,7% vs 9.8% ; p <0.05). Alcoholism was noted in 14.2% (G1)
versus 13.6% (G2) (p> 0.05). Consultation time was significantly shorter in G2 (58 days vs 346 days ; p = 0.045).
Radiological findings were extensive or bilateral in 40.9% of G2 cases vs 46% of G1 without significant difference.
Side effects related to anti-TB treatment were more noted in G1 (79.3% vs 68.2%) but there was no statistically
difference. According of recovery and treatment failure there was no significant difference (G1 : 46% vs G2 : 31.8%)
and (3.1% G1 vs 4.5% ).

Conclusion

Our study confirms the link between tobacco and MR-TB in its acquired form. The consequences of primary or
secondary MDR-TB are in all cases serious and heavy for the patient and for society.

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