Isoniazid-Resistant Tuberculous Meningitis in the US
Author Information
Author(s): Vinnard Christopher, Winston Carla A., Wileyto E. Paul, MacGregor Rob Roy, Bisson Gregory P.
Primary Institution: University of Pennsylvania School of Medicine
Hypothesis
What patient characteristics are associated with isoniazid resistance in cases of tuberculous meningitis?
Conclusion
Foreign-born patients with tuberculous meningitis are more likely to be infected with isoniazid-resistant strains compared to US-born patients.
Supporting Evidence
- Foreign-born patients had an odds ratio of 2.53 for isoniazid resistance compared to US-born patients.
- Initial isoniazid resistance was uncommon in persons over 64 years of age.
- HIV infection was not associated with initial isoniazid resistance.
Takeaway
This study found that people born outside the US are more likely to have a type of tuberculosis that doesn't respond to a common medicine called isoniazid.
Methodology
A cross-sectional study using data from the US National Tuberculosis Surveillance System from 1993 to 2005.
Potential Biases
Potential bias due to missing HIV status for 47% of patients.
Limitations
Individual MIC levels for isoniazid were unavailable, and the study could not identify patients previously treated for latent TB.
Participant Demographics
The study included patients diagnosed with tuberculous meningitis, with a mix of foreign-born and US-born individuals.
Statistical Information
P-Value
<0.01
Confidence Interval
95% CI 1.66–3.88
Statistical Significance
p<0.01
Digital Object Identifier (DOI)
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