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Clinical analysis of 5 cases of drug-resistant tuberculosis

??Objective??To summarize the clinical characteristics of drug-resistant tuberculosis in children and improve the level of diagnosis and treatment of the disease. Methods??The clinical data of 5 children with drug-resistant tuberculosis treated in Beijing Children’s Hospital from March 2013 to March 2017 were retrospectively analyzed. Clinical data included general information??tuberculosis exposure history??clinical and imaging performance??etiological examination??drug sensitivity test??treatment protocol and outcome. All five patients??4 male and 1 female?? had pulmonary tuberculosis??two had tuberculous meningitis??four had bronchial tuberculosis. Results??All had laboratory-confirmed drug-resistant tuberculosis??two were with rifampicin-resistant tuberculosis??RR-TB?? confirmed by Xpert MTB/RIF??one had confirmed by multidrug-resistant tuberculosis??MDR-TB?? cervical lymph node puncture fluid culture??one had by pre-extensive drug- resistant tuberculosis??Pre-XDR?? sputum culture and the other case was MDR-TB confirmed by the positive culture of his father’s sputum. All patients received regimens recommended by WHO??containing second-line anti-tuberculosis drugs??after diagnosis of drug-resistant tuberculosis. Two children were cured??two children were improved??but still receiving anti-tuberculosis treatment. Treatment failed in one child. All children had no severe adverse events. Conclusion??The drug-resistant tuberculosis in children can be diagnosed by molecular technique Xpert MTB/RIF and mycobacterium tuberculosis culture. The molecular technique is of great value in early and rapid diagnosis of drug-resistant tuberculosis. Most children with drug-resistant tuberculosis have a favourable prognosis after timely and effective treatment. The incidence of serious adverse effects of second-line anti-tuberculosis drugs is low in children.