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Predictor of MDR TB

Omowunmi Aibana, Mariya Bachmaha, Viatcheslav Krasiuk, Natasha Rybak, Timothy P Flanigan, Vasyl Petrenko, Megan B Murray
BACKGROUND: Ukraine is among ten countries with the highest burden of multidrug- resistant TB (MDR-TB) worldwide. Treatment success rates for MDR-TB in Ukraine remain below global success rates as reported by the World Health Organization. Few studies have evaluated predictors of poor MDR-TB outcomes in Ukraine. METHODS: We conducted a retrospective analysis of patients initiated on MDR-TB treatment in the Kyiv Oblast of Ukraine between January 01, 2012 and March 31st, 2015...
February 7, 2017: BMC Infectious Diseases
Meng-Yu Chen, Yi-Chun Lo, Wan-Chin Chen, Kwei-Feng Wang, Pei-Chun Chan
Recurrence after successful treatment for multidrug-resistant tuberculosis (MDR-TB) is challenging because of limited retreatment options. This study aimed to determine rates and predictors of MDR-TB recurrence after successful treatment in Taiwan. Recurrence rates were analyzed by time from treatment completion in 295 M DR-TB patients in a national cohort. Factors associated with MDR-TB recurrence were examined using a multivariate Cox regression analysis. Ten (3%) patients experienced MDR-TB recurrence during a median follow-up of 4...
2017: PloS One
Bassirou Diarra, Aissata B Cissé, Ousmane Kodio, Moumine Sanogo, Bocar Baya, Antieme C G Togo, Amadou Somboro, Mohamed Tolofoudié, Boureima Degoga, Marie Laure Keita, Fatimata Diallo, Natacha Nguiakam, Gagni Coulibaly, Sidy Bane, Yeya Dit Sadio Sarro, Seydou Doumbia, Robert Leo Murphy, Souleymane Diallo, Bouke C Dejong
OBJECTIVE/BACKGROUND: The recent call for universal drug susceptibility testing (DST) for all tuberculosis (TB) patients will be difficult to meet in settings where Xpert rollout is limited, such as low prevalence of HIV and Multi-drug Resistant Tuberculosis (MDR) settings. As recommended by World Health Organization (WHO) guidelines, the success of TB treatment is measured by Ziehl-Neelsen (ZN) microscopy or auramine-rhodamine fluorescent microscopy (FM) on sputum, in which conversion to negative smear at 2months (M) is an important predictor of treatment success, defined as a negative smear at 5M...
December 2016: International Journal of Mycobacteriology
Dmytro O Butov, Mykhailo Kuzhko, Tatyana Butova, Ganna Stepanenko
OBJECTIVE/BACKGROUND: There is a paucity of published data on the effect of tuberculosis (TB) chemotherapy on nitric oxide (NO) synthesis and metabolism in newly diagnosed and relapsed patients with or without multidrug-resistant TB (MDR-TB). METHODS: The pattern of NO response in 140 patients with pulmonary TB, including 74 with MDR-TB (1st group) and 66 without MDR-TB (2nd group) has been studied and compared with the NO status of 30 healthy donors (3rd group)...
December 2016: International Journal of Mycobacteriology
Setegn Eshetie, Feleke Moges, Mulat Dagnew
OBJECTIVES/BACKGROUND: Efforts to control the global burden of tuberculosis (TB) epidemic have now been jeopardized by the rapid evolution of drug-resistant Mycobacterium tuberculosis (MTB), which are resistant to one or more anti-TB drugs. Multidrug resistant (MDR) TB in Ethiopia may be more prevalent than previously appreciated; thus, up-to-date national drug resistance studies are critically needed. Therefore, this meta-analysis aimed, first, to determine pooled prevalence of MDR TB among newly diagnosed and previously treated TB cases, and second, to measure the association between previous anti-TB exposure and acquisition of MDR-MTB infection...
December 2016: International Journal of Mycobacteriology
Kefyalew Addis Alene, Kerri Viney, Emma S McBryde, Adino Tesfahun Tsegaye, Archie C A Clements
OBJECTIVE: Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Ethiopia. The aim of this study was to assess MDR-TB treatment outcomes and determine predictors of poor treatment outcomes in north-west Ethiopia. METHODS: A retrospective cohort study was conducted using all MDR-TB patients who were enrolled at Gondar University Hospital since the establishment of the MDR-TB programme in 2010. A Cox proportional hazard model was used to identify the predictors of time to poor treatment outcomes, which were defined as death or treatment failure...
December 15, 2016: Tropical Medicine & International Health: TM & IH
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 (embB306) have been proposed to be a potential marker for EMB resistance and a predictor of broad drug resistance in clinical Mycobacterium tuberculosis isolates. However, discordant findings about the association between embB306 mutations and EMB resistance were reported. Hebei Province is located in the Beijing-Tianjin-Hebei integration region in China; however, little information about the genetic diversity of the embB locus in this area is available...
December 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...
November 2016: 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
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