Turning Off the Tap: Using the FAST Approach to Stop the Spread of Drug-Resistant Tuberculosis in the Russian Federation. (5th April 2018)

• Record Type: Journal Article
• Authors: Miller, Ann C; Livchits, Viktoria; Ahmad Khan, Faiz; Atwood, Sidney; Kornienko, Sergei; Kononenko, Yulia; Vasilyeva, Irina; Keshavjee, Salmaan
• Is Part Of: Journal of infectious diseases. Volume 218:Number 4(2018)
• Page Start: 654
• Page End: 658
• Publication Date: 2018-04-05
• Subjects: Multidrug-resistant tuberculosis -- nosocomial transmission -- hospital infection control -- Russian Federation -- tuberculosis; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiy190
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract : Nosocomial transmission contributes to the spread of multidrug-resistant (MDR) tuberculosis to patients with drug-susceptible tuberculosis. Use of the FAST strategy in 2 Russian hospitals was associated with significantly less MDR tuberculosis after 12 months. Abstract: Background: We report the association of the FAST strategy (find cases actively, separate safely, and treat effectively) with reduction of hospital-based acquisition of multidrug-resistant tuberculosis in the Russian Federation. Methods: We used preintervention and postintervention cohorts in 2 Russian hospitals to determine whether the FAST strategy was associated with a reduced odds of converting MDR tuberculosis within 12 months among patients with tuberculosis susceptible to isoniazid and rifampin at baseline. Results: Sixty-three of 709 patients (8.9%) with isoniazid and rifampin–susceptible tuberculosis acquired MDR tuberculosis; 55 (12.2%) were in the early cohort, and 8 (3.1%) were in the FAST cohort. The FAST strategy was associated with a reduced odds (adjusted odds ratio, 0.16; 95% confidence interval, .07–.39) and 9.2% absolute reduction in the risk of MDR tuberculosis acquisition. Conclusion: Use of the FAST strategy in 2 Russian hospitals was associated with significantly less MDR tuberculosis 12 months after implementation.