{"doi":"10.1371/journal.pone.0270201","title":"Long term outcomes of patients with tuberculous meningitis: The impact of drug resistance","abstract":"BACKGROUND: Little is known about the impact of drug-resistance on clinical outcomes among patients with tuberculosis meningitis (TBM). METHODS: A retrospective cohort study among patients treated for TBM in Tbilisi, Georgia. We performed medical chart abstraction to collect patient data. Long-term vital status was assessed using the Georgia National Death Registry. We utilized a Cox proportional-hazards model to evaluate the association of drug-resistance and mortality. RESULTS: Among 343 TBM suspects, 237 had a presentation consistent with TBM. Drug resistance was suspected (n = 5) or confirmed (n = 31) in 36 patients including 30 with multidrug- or rifampin-resistance and 6 with isoniazid-resistance. Thirty-four patients had HIV. The median follow-up time was 1331 days (IQR, 852-1767). Overall, 73 of 237 (30%) people died with 50 deaths occurring during and 23 after treatment. The proportion of death was higher among patients with drug-resistant vs. drug-susceptible disease (67% vs. 24%, p<0.001) and with HIV versus no HIV (59% vs 27%, p<0.001). Mortality was significantly higher in patients with drug-resistant TBM after 90 days of treatment (aHR = 7.2, CI95% [3.6-14.3], p < 0.001). CONCLUSIONS: Mortality was high among patients with drug-resistant TBM with many deaths occurring post treatment. More effective treatment options are urgently needed for drug-resistant TBM.","journal":"PLoS ONE","year":2022,"id":240721,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":44,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9373,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":668926,"name":"Teona Avaliani","orcid":"0000-0001-8587-7650","position":1,"is_corresponding":false},{"id":669944,"name":"Mariam Gujabidze","orcid":null,"position":2,"is_corresponding":false},{"id":669945,"name":"Tinatin Bakuradze","orcid":null,"position":3,"is_corresponding":false},{"id":338061,"name":"Maia Kipiani","orcid":null,"position":4,"is_corresponding":false},{"id":669946,"name":"Shorena Sabanadze","orcid":null,"position":5,"is_corresponding":false},{"id":668925,"name":"Alison Smith","orcid":"0000-0001-9007-6823","position":6,"is_corresponding":false},{"id":385103,"name":"Zaza Avaliani","orcid":"0000-0002-8790-3282","position":7,"is_corresponding":false},{"id":364035,"name":"Jeffrey M. Collins","orcid":"0000-0002-6574-0873","position":8,"is_corresponding":false},{"id":332451,"name":"Russell R. Kempker","orcid":"0000-0002-7188-4996","position":9,"is_corresponding":false},{"id":452982,"name":"Emily E Evans","orcid":"0009-0003-7185-5188","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T00:22:51.435773Z","pmid":"35749509","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}