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Predictor of MDR TB

Yanan Li, Yuling Wang, Zhi Zhang, Huixia Gao, Haibin Wang, Jinfeng Cao, Shumin Zhang, Yuzhen Liu, Jianhua Lu, Zungui Xu, Erhei Dai
Ethambutol (EMB) is an essential first-line drug for tuberculosis (TB) treatment. Nucleotide substitutions at embB codon 306 have been proposed as a potential marker for EMB resistance and a predictor for broad drug resistance in clinical Mycobacterium tuberculosis (MTB) isolates. However, discordant findings about the association between embB306 mutation and EMB resistance were reported. The Hebei province is located in the Beijing-Tianjin-Hebei integration region; however, little information about the genetic diversity of embB locus is available in this area...
September 26, 2016: Antimicrobial Agents and Chemotherapy
Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin
The emergence of drug-resistant tuberculosis (TB) is a major public health threat. However, little is known about the predictors of death in drug-resistant TB in Malaysia. This study aimed to determine the predictors of death in drug-resistant TB patients, including multidrug-resistant TB (MDR-TB), in Kuala Lumpur, Malaysia. This study adopted a retrospective cohort study design and involved laboratory-confirmed drug-resistant TB patients (n=426) from January 2009 to June 2013. A Cox regression model and Kaplan-Meier curves were used to model the outcome measure...
September 2016: Journal of Global Antimicrobial Resistance
Nafees Ahmad, Arshad Javaid, Syed Azhar Syed Sulaiman, Anila Basit, Afsar Khan Afridi, Ammar Ali Saleh Jaber, Amer Hayat Khan
BACKGROUND: At present, within the management of multidrug resistant tuberculosis (MDR-TB) much attention is being paid to the traditional microbiological and clinical indicators. Evaluation of the impact of MDR-TB treatment on patients' Health Related Quality of Life (HRQoL) has remained a neglected area. OBJECTIVE: To evaluate the impact of MDR-TB treatment on patients HRQoL, and determine the predictors of variability in HRQoL along the course of treatment. METHODS: A prospective follow up study was conducted at the programmatic management unit for drug resistant TB of Lady Reading Hospital Peshawar...
2016: PloS One
Chawangwa Modongo, Jotam G Pasipanodya, Beki T Magazi, Shashikant Srivastava, Nicola M Zetola, Scott M Williams, Giorgio Sirugo, Tawanda Gumbo
Aminoglycosides such as amikacin continue to be part of the backbone of treatment of multidrug-resistant tuberculosis (MDR-TB). We measured amikacin concentrations in 28 MDR-TB patients in Botswana receiving amikacin therapy together with oral levofloxacin, ethionamide, cycloserine, and pyrazinamide and calculated areas under the concentration-time curves from 0 to 24 h (AUC0-24). The patients were followed monthly for sputum culture conversion based on liquid cultures. The median duration of amikacin therapy was 184 (range, 28 to 866) days, at a median dose of 17...
October 2016: Antimicrobial Agents and Chemotherapy
Silvia S Chiang, Jeffrey R Starke, Ann C Miller, Andrea T Cruz, Hernán Del Castillo, William José Valdivia, Gabriela Tunque, Fanny García, Carmen Contreras, Leonid Lecca, Valentina A Alarcón, Mercedes C Becerra
BACKGROUND: Globally, >30 000 children fall sick with multidrug-resistant (MDR) tuberculosis every year. Without robust pediatric data, clinical management follows international guidelines that are based on studies in adults and expert opinion. We aimed to identify baseline predictors of death, treatment failure, and loss to follow-up among children with MDR tuberculosis disease treated with regimens tailored to their drug susceptibility test (DST) result or to the DST result of a source case...
October 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Xubin Zheng, Rongrong Zheng, Yi Hu, Jim Werngren, Lina Davies Forsman, Mikael Mansjö, Biao Xu, Sven Hoffner
Our study aims to identify the clinical breakpoints (CBPs) of second-line drugs (SLDs) above which standard therapy fails in order to improve multidrug-resistant tuberculosis (MDR-TB) treatment. MICs of SLDs were determined for M. tuberculosis isolates cultured from 207 MDR-TB patients in a prospective cohort study in China between January 2010 and December 2012. Classification and regression tree (CART) analysis was used to identify the CBPs predictive of treatment outcome. Of the 207 MDR-TB isolates included in the present study, the proportion of isolates above the critical concentration recommended by WHO ranged from 5...
August 2016: Antimicrobial Agents and Chemotherapy
Rebecca C Harris, Louis Grandjean, Laura J Martin, Alexander J P Miller, Joseph-Egre N Nkang, Victoria Allen, Mishal S Khan, Katherine Fielding, David A J Moore
BACKGROUND: Globally it is estimated that 480 000 people developed multidrug-resistant tuberculosis (MDR-TB) in 2014 and 190 000 people died from the disease. Successful treatment outcomes are achieved in only 50 % of patients with MDR-TB, compared to 86 % for drug susceptible disease. It is widely held that delay in time to initiation of treatment for MDR-TB is an important predictor of treatment outcome. The objective of this review was to assess the existing evidence on the outcomes of multidrug- and extensively drug-resistant tuberculosis patients treated early (≤4 weeks) versus late (>4 weeks) after diagnosis of drug resistance...
May 4, 2016: BMC Infectious Diseases
Abiola O Olaleye, Andy K Beke
BACKGROUND: A retrospective cohort study was carried out to compare the survival between smear-positive patients and smear-negative multidrug resistant tuberculosis (MDR-TB) patients hospitalised in a specialised TB hospital in Witbank, South Africa. METHODS: A review of medical records of MDR-TB patients treated from 2001 to 2010 was carried out. Survival time was measured from a patient's date of hospitalisation to the date when the patient died, was last treated at the hospital or the end of the study (whichever came first)...
2016: Infectious Diseases
Martie van der Walt, Joey Lancaster, Karen Shean
INTRODUCTION: South Africa has the highest reported rates of multi-drug resistant TB in Africa, typified by poor treatment outcomes, attributable mainly to high default and death rates. Concomitant HIV has become the strongest predictor of death among MDR-TB patients, while anti-retroviral therapy (ART) has dramatically reduced mortality. TB Case fatality rate (CFR) is an indicator that specifically reports on deaths due to TB. AIM: The aim of this paper was to investigate causes of death amongst MDR-TB patients, the contribution of conditions other than TB to deaths, and to determine if causes differ between HIV-uninfected patients, HIV-infected patients receiving ART and those without ART...
2016: PloS One
Mohsen A Gadallah, Alaa Mokhtar, Mervat Rady, Essam El-Moghazy, Magdy Fawzy, Sahar Khalil Kandil
BACKGROUND/PURPOSE: Multidrug-resistant tuberculosis (MDR-TB) represents 5% of TB cases globally. In Egypt, it represents 11.4% of TB cases (2.2% of new and 38.2% of previously treated). Our objectives were to evaluate the treatment outcomes and determine the associated prognostic factors among the first national treatment cohort of MDR-TB from 2006 to 2010. METHODS: All patients diagnosed with MDR-TB from July 2006 to December 2010 who were admitted to Abbassia Chest Hospital, the first Egyptian national center established for MDR-TB treatment, were included...
December 13, 2015: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Mazhar A Khan, Sumaira Mehreen, Anila Basit, Raza A Khan, Faheem Jan, Irfan Ullah, Muhammad Ihtesham, Afsar Khan, Ubaid Ullah, Arshad Javaid
OBJECTIVES: To determine characteristics and treatment outcomes of multidrugs resistant tuberculosis (MDR-TB) patients and risk factors for poor outcomes in MDR-TB patients in a tertiary care hospital in Peshawar, Pakistan.  METHODS: This retrospective study was conducted at the Programmatic Management of Drug Resistant TB Unit, Lady Reading Hospital Peshawar, Pakistan and included all MDR-TB patients registered between January 2012 and December 2012. A special proforma was used for data collection...
December 2015: Saudi Medical Journal
Teye Umanah, Jabulani Ncayiyana, Xavier Padanilam, Peter S Nyasulu
BACKGROUND: Multidrug resistant-tuberculosis (MDR-TB) is a threat to global tuberculosis control which is worsened by human immune-deficiency virus (HIV) co-infection. There is however paucity of data on the effects of antiretroviral treatment (ART) before or after starting MDR-TB treatment. This study determined predictors of mortality and treatment failure among HIV co-infected MDR-TB patients on ART. METHODS: A retrospective medical record review of 1200 HIV co-infected MDR-TB patients admitted at Sizwe Tropical Disease Hospital, Johannesburg from 2007 to 2010 was performed...
October 28, 2015: BMC Infectious Diseases
Daniel Meressa, Rocío M Hurtado, Jason R Andrews, Ermias Diro, Kassim Abato, Tewodros Daniel, Paritosh Prasad, Rebekah Prasad, Bekele Fekade, Yared Tedla, Hanan Yusuf, Melaku Tadesse, Dawit Tefera, Abraham Ashenafi, Girma Desta, Getachew Aderaye, Kristian Olson, Sok Thim, Anne E Goldfeld
BACKGROUND: In Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated, with poor outcomes reported for HIV-coinfected patients. METHODS: A standardised second-line drug (SLD) regimen was used in a non-governmental organisation-Ministry of Health (NGO-MOH) collaborative community and hospital-based programme in Ethiopia that included intensive side effect monitoring, adherence strategies and nutritional supplementation...
December 2015: Thorax
Yanni Sun, David Harley, Hassan Vally, Adrian Sleigh
BACKGROUND: We conducted a cohort study to compare the characteristics of MDR-TB with non-MDR-TB patients and to measure long term (9-year) mortality rate and determine factors associated with death in China. METHODS: We reviewed the medical records of 250 TB cases from a 2001 survey to compare 100 MDR-TB patients with 150 non-MDR-TB patients who were treated in 2001-2002. Baseline attributes extracted from the records were compared between the two cohorts and long-term mortality and risk factors were determined at nine-year follow-up in 2010...
2015: BMC Public Health
Girma Mulisa, Tilaye Workneh, Niguse Hordofa, Mohamed Suaudi, Gemeda Abebe, Godana Jarso
OBJECTIVE: The aim of this study was to determine risk factors for tuberculosis (TB) caused by multidrug-resistant Mycobacterium tuberculosis (MDR-TB) in Oromia Region, Ethiopia. METHODS: A 6-month case-control study was performed in 2013-14. Sputum samples and standardized questionnaire data (demographics, treatment, TB contact history, underlying disease, history of imprisonment) were collected from cases with suspected MDR-TB aged ≥ 18 years. Sputum was processed locally in the Oromia Public Health Laboratory using standard techniques...
October 2015: International Journal of Infectious Diseases: IJID
Jiang-Nan Zhao, Xian-Xin Zhang, Xiao-Chun He, Guo-Ru Yang, Xiao-Qi Zhang, Wen-Gen Xin, Huai-Chen Li
BACKGROUND: Relatively little is known about the specific relationship and impact from chronic obstructive pulmonary disease (COPD) on multidrug-resistant tuberculsosis (MDR-TB). METHODS: We conducted a retrospective study included patients aged ≥40 years with a confirmed pulmonary TB at three tertiary hospitals (Shandong, China) between January 2011 and October 2014. Univariable and multivariable analyses were performed to identify the relationship of MDR-TB and COPD...
2015: PloS One
N Ahmad, A Javaid, A Basit, A K Afridi, M A Khan, I Ahmad, S A S Sulaiman, A H Khan
SETTINGS: Although Pakistan has a high burden of multidrug-resistant tuberculosis (MDR-TB), little is known about the management and treatment outcomes of MDR-TB patients in Pakistan. OBJECTIVE: To evaluate management and predictors of unsuccessful treatment outcomes among MDR-TB patients. METHODS: In this observational cohort study, 196 MDR-TB patients enrolled at the Programmatic Management Unit for drug-resistant TB of Lady Reading Hospital, Peshawar, Pakistan, between 1 January 2012 and 28 February 2013 were included...
September 2015: International Journal of Tuberculosis and Lung Disease
Li-Li Zhao, Hai-Can Liu, Qing Sun, Tong-Yang Xiao, Xiu-Qin Zhao, Gui-Lian Li, Chun-Yan Zeng, Kang-Lin Wan
We investigated the spectrum and frequency of mutations in rpsL, rrs, and gidB among 140 multidrug-resistant tuberculosis (MDR-TB) clinical isolates from China. The association between mutations and different genotypes was also analyzed. Our data revealed that 65.7% of MDR-TB were resistant to streptomycin (STR), and 90.2% of STR-resistant isolates were Beijing strains. STR resistance was correlated with Beijing family (P=0.00). Compared with phenotypic data, detection of mutations for the combination of these 3 genes exhibited 94...
October 2015: Diagnostic Microbiology and Infectious Disease
S M Liew, E M Khoo, B K Ho, Y K Lee, O Mimi, M Y Fazlina, R Asmah, W K Lee, M Y Harmy, K Chinna, F D Jiloris
OBJECTIVES: To determine treatment outcomes and associated predictors of all patients registered in 2012 with the Malaysian National Tuberculosis (TB) Surveillance Registry. METHODS: Sociodemographic and clinical data were analysed. Unfavourable outcomes included treatment failure, transferred out and lost to follow-up, treatment defaulters, those not evaluated and all-cause mortality. RESULTS: In total, 21 582 patients were registered. The mean age was 42...
July 2015: International Journal of Tuberculosis and Lung Disease
Elize Pietersen, Jonny Peter, Elizabeth Streicher, Frik Sirgel, Neesha Rockwood, Barbara Mastrapa, Julian Te Riele, Malika Davids, Paul van Helden, Robin Warren, Keertan Dheda
BACKGROUND: There are limited data about the epidemiology and treatment-related outcomes associated with capreomycin resistance in patients with XDR-TB. Capreomycin achieves high serum concentrations relative to MIC but whether capreomycin has therapeutic benefit despite microbiological resistance remains unclear. METHODS: We reviewed the susceptibility profiles and outcomes associated with capreomycin usage in patients diagnosed with XDR-TB between August 2002 and October 2012 in two provinces of South Africa...
2015: PloS One
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