Drug-resistant Tuberculosis In Children Research Articles

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013-2022.

To investigate the status of the drug-resistant tuberculosis (DR-TB) among children in Sichuan, and to find out the risk factors and high-risk population related to drug resistance among children. The clinical data of tuberculosis patients ≤14 years old with culture-confirmed tuberculosis hospitalized in Chengdu Public Health Clinical Center from January 2013 through December 2022 were collected. Clinical data such as gender, age, ethnicity, history of anti-TB treatment, history of exposure to tuberculosis, nutritional status, and specific drug resistance of the children were collected and recorded. The drug resistance of children in different age groups (0-4 years old, 5-9 years old, 10-14 years old) and different periods (2013-2017 and 2018-2022) were grouped and compared. Logistic regression analysis was to analyze analysis of risk factors of drug resistance in children. A total of 438 children with culture-confirmed tuberculosis were screened. Among them, 26.19% (11/42) were 0 to 4 years old, 33.33% (22/66) were 5 to 9 years old, and 36.67% (121/330) were 10 to 14 years old among the resistant children. There was no statistically significant difference in the resistance rate among the 3 groups (P = .385). The proportions of DR-TB, monoresistant tuberculosis, polydrug-resistant tuberculosis were decreased during 2019 to 2022 compared with 2013 to 2017 (P < .0001). The resistance rates of drug resistant, monoresistant, polydrug-resistant, isoniazid-resistant, and rifampicin resistant during 2018 to 2022 were decreased compared with those from 2013 to 2017 (P < .05), but the multi-drug resistance rate was not decreased (P = .131, without statistical difference). The results of logistic regression analysis showed that male gender OR = 1.566 (95% CI 1.035-2.369), a history of antituberculosis therapy OR = 4.049 (95% CI 1.442-11.367), and pulmonary and extrapulmonary tuberculosis OR = 7.335 (95% CI 1.401-38.392) were risk factors for the development of drug resistance; but fever OR = 0.581 (95% CI 0.355-0.950) was Protective factor. The total drug resistance rate of children in Sichuan showed a downward trend, but the rate of multi-drug-resistant tuberculosis was still at a high level, and the form of drug resistance was still severe. Absence of fever, male, retreatment, and pulmonary concurrent with extrapulmonary tuberculosis are risk factors for DR-TB in children.

Prevalence Of Rifampicin Resistance in New Cases Of Pulmonary Tuberculosis In Children

Objective: The research aims to determine the prevalence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases, investigating the frequency of resistance to this first-line antibiotic. By doing so, it seeks to provide insights into rifampicin's effectiveness as a treatment and contribute to understanding drug-resistant tuberculosis in children. Methods: The investigation employed a cross-sectional design to evaluate the presence of rifampicin resistance in newly diagnosed pediatric pulmonary tuberculosis cases. Executed in Lahore, Pakistan, it adopted a convenience sampling strategy with a sample size of 100. The research entailed screening children displaying symptoms of TB, acquiring written consent, and gathering demographic and clinical data, encompassing bacterial load and evidence of antibiotics. Sputum samples were processed employing the Xpert MTB/RIF assay. Statistical analyses, encompassing descriptive statistics and prevalence calculations, were executed utilizing the SPSS software. The investigation underscored the significance of resilient diagnostics, early identification, and tailored interventions for the management of drug-resistant TB in children. Results: The study provides valuable insights into rifampicin resistance among children with pulmonary tuberculosis. These findings highlight the importance of regular monitoring and appropriate treatment strategies to combat drug-resistant tuberculosis in pediatric populations. Further research and interventions are warranted to minimize the emergence and spread of drug-resistant strains in this vulnerable population. Conclusion: The study highlights the need for continuous monitoring of drug resistance patterns in children with tuberculosis, particularly concerning rifampicin, a crucial first-line antibiotic. The higher resistance rate suggests exploring alternative treatment options, optimising drug regimens, and developing interventions to prevent and manage drug-resistant tuberculosis effectively in children. Keywords: Antibiotics, Disease, Paeds, Resistance, Susceptibility, Tuberculosis.

An insight into the burden of drug-resistant tuberculosis in children.

An insight into the burden of drug-resistant tuberculosis in children.

Non-Injection Chemotherapy Regimens for Drug Resistant Tuberculosis in Children and Adolescents

The objective: to determine the effectiveness and safety (tolerability) of non-injection chemotherapy regimens containing bedaquiline in pediatric patients with multiple drug resistant respiratory tuberculosis.Subjects and Methods. Effectiveness and safety of treatment regimens containing non-injection drugs and Bdq were studied in 45 children from Main Group (MG) aged from 5 to 17 years old inclusive who were ill with multiple drug resistant tuberculosis. Control Group (CG) included patients of the same age with MDR TB who were treated with chemotherapy regimens containing injectable drugs (a retrospective study).Results. After 24 weeks (the period during which patients took bedaquiline), clinical effectiveness of chemotherapy regimens was achieved in all patients. By the end of week 24 of treatment, significant positive radiographic changes were noted in 84.4% of patients in MG and in 75.7% in CG (OR 1.741; 95% CI 0.658–4.611), healing of cavities was achieved in 42 (93.3%) and 66 (94.3%) patients, respectively (OR 0.848, 95% CI 0.181-3.982). No tuberculous mycobacteria were not detected in 100% of cases in both groups by month 6 of chemotherapy. The number of adverse reactions (AR) per patient averaged 1.25 and 1.26 in MG and CG. ARs occurred in patients receiving aminoglycosides in 41.4%: in MG – in 33.3%; 4/70 (5.7%) children from CG receiving injectable drugs developed adverse reactions requiring replacement of anti-tuberculosis drugs. No irreversible ARs were observed in MG.

Current Treatment of Drug-Resistant Tuberculosis in Children.

Optimal diagnosis and management of children aged <15 y with rifampicin- or multidrug-resistant tuberculosis (RR/MDR-TB) relies on identification of adults with the disease and pro-active screening of their close contacts. Children may be diagnosed with RR/MDR-TB based on microbiological confirmation from clinical specimens (sputum, gastric washings, stool), but usually the diagnosis is presumptive, with a history of exposure to RR/MDR-TB and clinical/radiological signs and symptoms suggestive of TB disease. RR/MDR-TB should also be considered in children where first-line TB treatment fails despite good adherence to therapy. Composition and duration of all-oral RR/MDR-TB treatment regimens in children are based on site and severity of TB disease, drug resistance profile of the Mycobacterium tuberculosis strain (isolated from the child or from the most likely source patient), inclusion of at least four drugs considered to be effective (with priority given to World Health Organization Group A and B drugs), toxicity and tolerability of medications (and feasibility of adverse effect monitoring in the child's setting), and availability of child-friendly formulations of TB medications. Individualized RR/MDR-TB regimens are preferable to the standardised 9-12-mo regimen for children, and injectable agents must not be used. Optimal adherence to treatment relies on education, training and support for caregivers and others who are responsible for administering medications to children, as well as close clinical monitoring and early management of adverse effects. Children who are initiated on adequate RR/MDR-TB regimens have high treatment success rates, but efforts to find and treat more children with undiagnosed RR/MDR-TB are crucial to reduce childhood TB mortality.

Analysis of Drug-Resistant Tuberculosis in Children in Shenyang, China, 2017-2021.

Drug-resistant tuberculosis (DR-TB) in children seriously threatens TB control. Information on the epidemiology and characteristics of DR-TB in children in China is limited. We studied data in Shenyang Tenth People's Hospital to understand the DR-TB epidemiology in children in Shenyang. We retrospectively analyzed drug resistance testing data of pediatric TB patients between 2017 and 2021, and included 2976 clinically-diagnosed pediatric TB patients. We described the epidemiology of DR-TB and analyzed the trends of DR-TB incidence. The Kappa value was calculated to assess the agreement between MGIT 960 DST and Xpert MTB/RIF for detecting rifampicin resistance. Multivariate logistic regression was used to identify the risk factors for DR-TB in pediatric patients. Of the 2976 TB patients, 1076 were confirmed by MGIT 960 culture and/or Xpert MTB/RIF. Among the 806 patients identified by MGIT 960 culture, 232 cases (28.78%) were DR-TB. Resistance to the six drugs was in the following order: streptomycin (21.09%), isoniazid (9.35%), rifampin (15.01%), levofloxacin (6.20%), ethambutol (4.22%), and amikacin (3.23%). Alarmingly, 12.90% were MDR-TB (104/806), including 28 (3.47%) pre-XDR-TB. Of the 1076 pediatric TB patients, 295 (27.4%) developed DR-TB to any one drug (including 69 rifampicin-resistant cases identified by Xpert MTB/RIF only). No difference was found in the incidence of pediatric DR-TB between 2017 and 2021. Among 376 patients who were positive for both methods, using the MGIT 960 DST results as the gold standard, Xpert MTB/RIF's sensitivity for detecting rifampicin resistance was 91.38% and its specificity was 94.65%. Between 2017 and 2021, the DR-TB incidence in children remained unchanged in Shenyang. RR-TB, MDR-TB, and even Pre-XDR-TB require attention in children with drug-resistant TB. Xpert MTB/RIF helped to detect more rifampicin-resistant pediatric patients; thus Xpert MTB/RIF should be widely used as an important complementary tool to detect rifampicin-resistant TB in children.

Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil

IntroductionDrug-resistant tuberculosis (DR-TB) is a global threat and a challenge for public health authorities worldwide. In children, the diagnosis is even more challenging and DR-TB is poorly described in the literature, as are its treatment outcomes. In this study, we aimed to describe the treatment of drug-resistant TB in children and young adolescents in Brazil. MethodsA descriptive epidemiological study of treatment for DR-TB in children under 15 years of age in Brazil between 2013 and 2020. The primary data source was the Information System for Special Tuberculosis Treatments (SITE-TB). Categorical variables were analyzed using relative frequencies (%) and continuous variables by measures of central tendency to characterize the profile of the cases, namely: sociodemographic, clinical characteristics, procedures, tests performed and treatment success. In order to verify the distribution of cases, a spatial analysis was carried out based on the municipality where the cases resided. ResultsBetween 2013 and 2020, 19,757 tuberculosis (TB) cases occurred in children aged <15 years in Brazil, and 46 cases of treatment for DR-TB were reported during the same period (annual average of 6 cases). Of these, 73.9% were aged 10–14, 65.2% were male, 4.3% were HIV+ and 43.3% were underweight (BMI<18.5) at the start of treatment. 17.4% had previous contact with TB, 69.6% had primary resistance, 47.8% multidrug resistance. The median duration of treatment was 15 months. DOT and standardized treatment regimen were performed in 52.2% of cases. Bacilloscopy was performed for 97.8% (57.8% positive); culture for 89.1% (75.6% positive), rapid molecular test for 73.9% with proven resistance to rifampicin in 55.8%. Susceptibility testing revealed resistance mainly to isoniazid (87.8%) and rifampicin (60.6%). 73.9% of cases were successfully treated and one death was reported. Cases were treated in 26 Brazilian municipalities, with the majority in Rio de Janeiro (15) and São Paulo (4). ConclusionDR-TB treatment was recorded in <1% of general TB cases in children and young adolescents, suggesting underreporting of drug-resistant cases in the country. Despite the low number of registered cases, the data reflect the situation of DR-TB in this population and describe important aspects of the problem, as the child needs comprehensive, individualized care, with support from different professionals. We recommend a strengthening of the country's referral services for the care of children with DR-TB so that surveillance and health care services can work together to identify and follow up cases.

Prevalence And Risk Factors Of Multi Drug Resistant Tuberculosis In Children.

To assess the prevalence of drug-resistant tuberculosis and to identify possible risk factors in children. The descriptive, interview-based study was conducted at the Pulmonology outdoor clinic of Jinnah Hospital, Lahore, Pakistan, from January to August 2019, and comprised children aged up to 14 years who were either contacts of a multi-drug resistant tuberculosis patients or non-contacts. Data related to their demography as well as clinical and social characteristics was collected using a questionnaire. Data was analysed using SPSS version 22. Of the 202 subjects, 115(56.9%) were girls and 87(43.1%) were boys. There were 70(34.7%) subjects aged >13 years, followed by 45(22.3%) aged 9-12 years, 44(21.8%) aged £4 years and 43(21.3%) aged 5-8 years. Overall, there were 26(12.9%) cases positive for multi-drug resistant tuberculosis; 16(61.5%) girls and 10(38.5%) boys. In terms of age, 17(65.4) cases were positive in those aged >13 years. Age, previous history of tuberculosis, co- infection with any immune-compromising disease and close contact with patients of multi-drug resistant tuberculosis were significant risk factors identified. The prevalence of multi-drug resistant tuberculosis was high in contacts of multi-drug resistant pulmonary tuberculosis patients, more prevalent in children aged 13-14 years.

Trends and challenges of multi-drug resistance in childhood tuberculosis.

Drug-resistant tuberculosis (DR-TB) in children is a growing global health concern, This review provides an overview of the current epidemiology of childhood TB and DR-TB, including prevalence, incidence, and mortality. We discuss the challenges in diagnosing TB and DR-TB in children and the limitations of current diagnostic tools. We summarize the challenges associated with treating multi-drug resistance TB in childhood, including limitations of current treatment options, drug adverse effects, prolonged regimens, and managing and monitoring during treatment. We highlight the urgent need for improved diagnosis and treatment of DR-TB in children. The treatment of children with multidrug-resistant tuberculosis will be expanded to include the evaluation of new drugs or new combinations of drugs. Basic research is needed to support the technological development of biomarkers to assess the phase of therapy, as well as the urgent need for improved diagnostic and treatment options.

World Health Organization Guideline on the Management of Tuberculosis in Children: Critical Appraisal, Concerns, and Caution.

In September 2022, the World Health Organization (WHO) published a new guideline for the management of tuberculosis (TB) in children and adolescents. It included eight new recommendations. Xpert MTB/RIF Ultra (Xpert Ultra) has been designated as the preferred initial diagnostic test for pulmonary TB and detection of rifampicin resistance. But its place vis-à-vis the previously recommended GeneXpert has not been clarified. Further, the limited diagnostic accuracy of Xpert Ultra in some biological specimens like nasopharyngeal aspirates, and the inability to report the presence or absence of rifampicin resistance in 'trace' reports has not been addressed. The guideline also recommends a shortened 4-mo treatment regimen for non-severe drug-susceptible TB. This is based on a single trial having several methodological issues that limit its applicability and generalizability. Interestingly, the criteria for designating 'non-severe' TB in the trial is based on smear negativity, whereas the new WHO recommendation is to omit smear microscopy altogether. The guideline also recommends an alternative 6-mo intensive regimen for drug-susceptible TB meningitis, which needs more supportive evidence. The lower age limits for the use of bedaquiline and delamanid have been decreased to less than 6 and 3 y respectively. While this makes it feasible to treat drug resistant TB in children with oral medications, the resource implications need careful consideration. These concerns advocate caution before the WHO guideline recommendations can be universally implemented.

Treating children with tuberculosis—Using pharmacometrics to do better

Treating children with tuberculosis—Using pharmacometrics to do better

Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape

ObjectivesGlobally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority. Bold country targets were established for 2018–2022. This study reviews the DR-TB situation in 2018, and the UNHLM target accomplishments in 10 high-burden countries (HBCs). MethodsAn ecological descriptive analysis of the top 10 DR-TB HBCs (Bangladesh, China, India, Indonesia, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, and South Africa), which share 70% of the global DR-TB burden, was undertaken, complemented by a cascade-of-care analysis and a survey gathering additional information on key advances and setbacks 2 years after the UNHLM declaration. ResultsMost countries are showing historic advances and are on track for the 2018 and 2019 targets. However, according to the cascade-of-care, none of the countries are capable of providing effective care for 50% of the estimated patients. Increasing levels of fluoroquinolone resistance and access to timely susceptibility testing can jeopardize ongoing adoption of shorter, all-oral treatment regimens. The programmatic management of DR-TB in children remains minimal. Achievements for 2020 and beyond may be affected significantly by the coronavirus disease 2019 (COVID-19) pandemic. ConclusionTriggered by the COVID-19 pandemic, there is a global risk of recoil in DR-TB care with long-term consequences in terms of deaths, suffering and wider transmission. Investment to support DR-TB services is more important now than ever to meet the aspirations of the UNHLM declaration.

Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Children: The Role of Bedaquiline and Delamanid.

Multidrug-resistant (MDR) tuberculosis (TB) has been emerging at an alarming rate over the last few years. It has been estimated that about 3% of all pediatric TB is MDR, meaning about 30,000 cases each year. Although most children with MDR-TB can be successfully treated, up to five years ago effective treatment was associated with a high incidence of severe adverse effects and patients with extensively drug-resistant (XDR) TB had limited treatment options and no standard regimen. The main objective of this manuscript is to discuss our present knowledge of the management of MDR- and XDR-TB in children, focusing on the characteristics and available evidence on the use of two promising new drugs: bedaquiline and delamanid. PubMed was used to search for all of the studies published up to November 2020 using key words such as “bedaquiline” and “delamanid” and “children” and “multidrug-resistant tuberculosis” and “extensively drug-resistant tuberculosis”. The search was limited to articles published in English and providing evidence-based data. Although data on pediatric population are limited and more studies are needed to confirm the efficacy and safety of bedaquiline and delamanid, their use in children with MDR-TB/XDR-TB appears to have good tolerability and efficacy. However, more evidence on these new anti-TB drugs is needed to better guide their use in children in order to design effective shorter regimens and reduce adverse effects, drug interactions, and therapeutic failure.

The use of reserve drugs in the chemotherapy of children and adolescents with tuberculosis

Introduction. The incidence of tuberculosis in children and adolescents is considered one of the most significant epidemiological indicators, which reflects the overall epidemic situation for tuberculosis. An urgent problem is the fact that the effectiveness of treatment of tuberculosis with MDR/XDR MBT in children and adolescents is not reflected in official statistics, and the tolerability of new anti-tuberculosis drugs in children with tuberculosis is not sufficiently studied at present. One of the drugs that can be used in the treatment of MDR-TB in children is linezolid. Objective. to evaluate the safety and efficacy of linezolid in chemotherapy regimens for drug-resistant tuberculosis in children. Results. in the structure of clinical forms of infiltrative tuberculosis — (32.0%), the primary tuberculosis complex was detected in 8 people (16.0%), TB of intra-thoracic lymph nodes also in 8 people (16.0%). MBT resistance to cycloserine and linezolid has not been reported in any patients. All patients received linezolid (100%). The development of undesirable side effects was observed in 14 people (28.0%). Linezolid caused in 3 people (6.0%) (adolescents 13 — 17 years old) undesirable adverse reactions of the type of polyneuropathy. The cessation of bacterial excretion was observed after 1 month in 100 % of cases. All children showed positive clinical dynamics and normalization of blood parameters in the period from 2 to 6 months of treatment. Positive radiological dynamics were also observed in the period from 2 to 6 months of treatment in the form of closure of the decay cavities, compaction, calcification and resorption of foci. Conclusion. Linezolid is a promising drug in children with tuberculosis who need the use of reserve drugs, since clinical efficacy is noted, MBT resistance is rarely developed, and the frequency of undesirable side reactions of regimens with the inclusion of linezolid does not exceed the frequency of those when prescribing regimens without the inclusion of linezolid

European guidance on drug-resistant tuberculosis in children and adolescents

The age-specific challenges for tuberculosis prevention and care in children and adolescents are increasingly recognised. However, addressing these challenges still requires greater focus by national tuberculosis programmes and increased public health prioritisation.

Pharmacokinetics of Levofloxacin in Children Treated for Exposure to Drug-Resistant Tuberculosis.

Levofloxacin is used to treat and prevent drug-resistant tuberculosis in children. We assessed levofloxacin serum drug concentrations in 24 children aged 2 to 10 years who received levofloxacin-based tuberculosis preventive therapy in Karachi, Pakistan. Only 9 children (37.5%) achieved adequate drug exposure. Target serum drug concentration was met in 4 (26.7%) of 15 children dosed consistently with World Health Organization recommendations and 4 (80.0%) of 5 who received higher-than-recommended doses. Levofloxacin dosing recommendations may require reevaluation.

Drug-Resistant Tuberculosis in Children and Adolescents in the Republic of Sakha (Yakutia)

Drug-Resistant Tuberculosis in Children and Adolescents in the Republic of Sakha (Yakutia)

ПЕРСОНИФИЦИРОВАННОЕ ЛЕЧЕНИЕ ТУБЕРКУЛЕЗА ЛЕГКИХ С МЛУ/ШЛУ МБТ У ПОДРОСТКОВ

The article presents 3 clinical cases of treatment of drug resistant tuberculosis in children and adolescents, illustrating the variants of the individual approach to treatment of tuberculosis with multiple/extensive drug resistance In order to improve treatment outcomes, bronchologic methods were used for the collection of specimens for bacteriological tests, chemotherapy regimens were adjusted in a timely manner, valve bronchial block (implantation of endobronchial valve) was used in one the patients to promote the cavity healing, the other patient underwent VATS resection of the upper lobe of the left lung due to numerous large foci As a result, it was possible to use a short course treatment in those patients

Delamanid and bedaquiline to treat multidrug-resistant and extensively drug-resistant tuberculosis in children: a systematic review.

The new drugs delamanid and bedaquiline are increasingly used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB). As evidence is lacking, the World Health Organization recommends their use under specific conditions in adults, delamanid only being recommended in children ≥6 years of age. No systematic review has yet evaluated the efficacy, safety and tolerability of the new drugs in children. A search of peer-reviewed, scientific evidence was performed, to evaluate the efficacy/effectiveness, safety, and tolerability of delamanid or bedaquiline-containing regimens in children with confirmed M/XDR-TB. We used PubMed and Embase to identify any relevant manuscripts in English until 31 December 2016, excluding editorials and reviews. Three out of 96 manuscripts retrieved satisfied the inclusion criteria, while 93 were excluded because dealing exclusively with adults (12: 4 on delamanid and 8 on bedaquiline), being recommendations or guidelines (8 manuscripts), reviews (17 papers) or other studies (56 papers). One of the studies retrieved reported evidence on 19 M/XDR-TB children, 16 of them treated under compassionate use with delamanid (13 achieving consistent bacteriological conversion) and 3 candidates for the drug. Two studies reported details on the first paediatric case treated (and cured) with a delamanid-containing regimen. Eight trials including children were also retrieved (clinicaltrials.gov). Although the methodology used in the study was rigorous, the results are limited by the paucity of the studies available in the literature on the use of new anti-TB drugs in children. In conclusion, more evidence is needed on the use of delamanid and bedaquiline in paediatric patients.

Clinical characteristics and therapeutic effect of drug-resistant tuberculosis in children

Objective: To explore the clinical characteristics of drug-resistant tuberculosis (TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions. Method: Retrospective research was conducted. The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively. Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions. χ(2) test was used. Result: Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate. The 46 children included 26 male and 20 female patients, aged from one month and 28 days to 17 years and 5 months, with the average age (8.4±4.5) years, >7 to 14 years old patients as the biggest part(25 patients, 54.3%). Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors). Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases, χ(2)=3.255, P=0.196). Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0% (40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46). Conclusion: The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low.