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Extensively drug-resistant pulmonary tuberculosis (XDR-TB) presents a worldwide threat to TB control. To identify risk factors for developing XDR-TB, investigators studied data from a national program that provides treatment for all TB cases in Estonia. Nearly 1200 people who had culture-confirmed pulmonary TB with clinical or radiographic features of active disease were treated from 2003 to 2005. Sixty of them had XDR-TB (defined as resistance to isoniazid and rifampicin, plus resistance to any fluoroquinolone and to at least one of three injectable TB drugs [capreomycin, kanamycin, or amikacin]).
In analyses adjusted for demographic, socioeconomic, and TB-related characteristics and for HIV status, risk factors for XDR-TB were previous ant…