{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T15:43:23Z","timestamp":1774280603634,"version":"3.50.1"},"reference-count":31,"publisher":"European Centre for Disease Control and Prevention (ECDC)","issue":"12","license":[{"start":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:00:00Z","timestamp":1553126400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,21]]},"abstract":"<jats:p>Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome.<\/jats:p>\n               <jats:p>Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union\/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB.<\/jats:p>\n               <jats:p>Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002\u201314 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries.<\/jats:p>\n               <jats:p>Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6\u20130.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age\u2009above\u2009median (OR: 1.3; 95% CI: 1.2\u20131.5), male sex (OR: 1.3; 95% CI: 1.1\u20131.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1\u20131.4), positive HIV status (OR: 3.3; 95% CI: 1.6\u20136.5) and a prior TB history (OR: 1.8; 95% CI: 1.5\u20132.2).<\/jats:p>\n               <jats:p>Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB.<\/jats:p>","DOI":"10.2807\/1560-7917.es.2019.24.12.1800392","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T08:55:17Z","timestamp":1553244917000},"update-policy":"https:\/\/doi.org\/10.2807\/1560-7917.es.crp2020","source":"Crossref","is-referenced-by-count":31,"title":["Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014"],"prefix":"10.2807","volume":"24","author":[{"given":"Basel","family":"Karo","sequence":"first","affiliation":[{"name":"These authors contributed equally to this article and share first authorship"},{"name":"Infectious Disease Department, Robert Koch Institute, Berlin, Germany"},{"name":"Field Epidemiology South East & London, National infection Service, Public Health England, London, United Kingdom"},{"name":"EPIET: European Programme of Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden"}]},{"given":"Anke","family":"Kohlenberg","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control, Stockholm, Sweden"},{"name":"These authors contributed equally to this article and share first authorship"}]},{"given":"Vahur","family":"Hollo","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control, Stockholm, Sweden"}]},{"given":"Raquel","family":"Duarte","sequence":"additional","affiliation":[{"name":"Directorate General of Health, Lisbon, Portugal"}]},{"given":"Lena","family":"Fiebig","sequence":"additional","affiliation":[{"name":"Apopo, Sokoine University of Agriculture, Morogoro, Tanzania"},{"name":"Infectious Disease Department, Robert Koch Institute, Berlin, Germany"}]},{"given":"Sarah","family":"Jackson","sequence":"additional","affiliation":[{"name":"Health Protection Surveillance Centre, Dublin, Ireland"}]},{"given":"Cathriona","family":"Kearns","sequence":"additional","affiliation":[{"name":"Public Health Agency, Belfast, Northern Ireland"}]},{"given":"Csaba","family":"K\u00f6dm\u00f6n","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control, Stockholm, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7693-9012","authenticated-orcid":false,"given":"Maria","family":"Korzeniewska-Kosela","sequence":"additional","affiliation":[{"name":"National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland"}]},{"given":"Dimitrios","family":"Papaventsis","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Mycobacteria, \u2018Sotiria\u2019 Chest Diseases Hospital, Athens, Greece"}]},{"given":"Ivan","family":"Solovic","sequence":"additional","affiliation":[{"name":"National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Catholic University Ruzomberok, Ruzomberok, Slovakia"}]},{"given":"Dick","family":"van Soolingen","sequence":"additional","affiliation":[{"name":"Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment, Bilthoven, The Netherlands"}]},{"given":"Marieke J.","family":"van der Werf","sequence":"additional","affiliation":[{"name":"European Centre for Disease Prevention and Control, Stockholm, Sweden"}]}],"member":"7995","reference":[{"key":"r1","unstructured":"World Health Organization (WHO). 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Available from: https:\/\/ecdc.europa.eu\/sites\/portal\/files\/media\/en\/publications\/Publications\/ecdc-tuberculosis-surveillance-monitoring-Europe-2017.pdf"},{"issue":"10","key":"r4","doi-asserted-by":"crossref","first-page":"20733","DOI":"10.2807\/1560-7917.ES2014.19.10.20733","article-title":"Drug resistance among tuberculosis cases in the European Union and European Economic Area, 2007 to 2012.","volume":"19","author":"van der Werf","year":"2014","journal-title":"Euro Surveill"},{"issue":"9","key":"r5","first-page":"796","article-title":"Role of individual drugs in the chemotherapy of tuberculosis.","volume":"4","author":"Mitchison","year":"2000","journal-title":"Int J Tuberc Lung Dis"},{"issue":"2","key":"r6","doi-asserted-by":"crossref","first-page":"129","DOI":"10.5588\/ijtld.16.0716","article-title":"Isoniazid-resistant tuberculosis: a cause for concern?","volume":"21","author":"Stagg","year":"2017","journal-title":"Int J Tuberc Lung Dis"},{"issue":"7","key":"r7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0022927","article-title":"Quantifying the burden and trends of isoniazid resistant tuberculosis, 1994-2009.","volume":"6","author":"Jenkins","year":"2011","journal-title":"PLoS One"},{"issue":"2","key":"r8","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S1473-3099(16)30407-8","article-title":"Treatment of isoniazid-resistant tuberculosis with first-line drugs: a systematic review and meta-analysis.","volume":"17","author":"Gegia","year":"2017","journal-title":"Lancet Infect Dis"},{"issue":"2","key":"r9","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1183\/09031936.00005613","article-title":"Comparing cost-effectiveness of standardised tuberculosis treatments given varying drug resistance.","volume":"43","author":"Law","year":"2014","journal-title":"Eur Respir J"},{"issue":"2","key":"r10","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1086\/595689","article-title":"Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis.","volume":"48","author":"Cattamanchi","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"4","key":"r11","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/cid\/cir406","article-title":"Treatment outcomes of isoniazid-resistant tuberculosis patients, Western Cape Province, South Africa.","volume":"53","author":"Jacobson","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"6","key":"r12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jinf.2010.03.017","article-title":"Isoniazid-resistant tuberculosis in Denmark: mutations, transmission and treatment outcome.","volume":"60","author":"Bang","year":"2010","journal-title":"J Infect"},{"issue":"11","key":"r13","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.5588\/ijtld.16.0293","article-title":"Outcome of culture-confirmed isoniazid-resistant rifampicin-susceptible tuberculosis in children.","volume":"20","author":"Garcia-Prats","year":"2016","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"r14","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1542\/peds.2015-0172","article-title":"Global and Regional Burden of Isoniazid-Resistant Tuberculosis.","volume":"136","author":"Yuen","year":"2015","journal-title":"Pediatrics"},{"issue":"7","key":"r15","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1097\/QAD.0000000000001016","article-title":"Impact of HIV infection on treatment outcome of tuberculosis in Europe.","volume":"30","author":"Karo","year":"2016","journal-title":"AIDS"},{"issue":"10","key":"r16","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1136\/thoraxjnl-2015-208262","article-title":"What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? 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Commission Regulation No 2119\/98\/EC of 24 September 1998 on setting up a network for the epidemiological surveillance and control of communicable diseases in the Community. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 3.10.1998:L 268\/1. 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